US8257356B2 - Guidewire exchange systems to treat spinal stenosis - Google Patents

Guidewire exchange systems to treat spinal stenosis Download PDF

Info

Publication number
US8257356B2
US8257356B2 US12/127,535 US12753508A US8257356B2 US 8257356 B2 US8257356 B2 US 8257356B2 US 12753508 A US12753508 A US 12753508A US 8257356 B2 US8257356 B2 US 8257356B2
Authority
US
United States
Prior art keywords
guidewire
surgical device
distal end
coupling
coupling member
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active, expires
Application number
US12/127,535
Other versions
US20080275458A1 (en
Inventor
Jeffrey L. Bleich
Gregory P. Schmitz
Roy Leguidleguid
Jefferey Bleam
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Spinal Elements Inc
Mis IP Holdings LLC
Original Assignee
Baxano Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US11/251,199 external-priority patent/US8192435B2/en
Priority claimed from US11/468,247 external-priority patent/US7857813B2/en
Priority to US12/127,535 priority Critical patent/US8257356B2/en
Application filed by Baxano Inc filed Critical Baxano Inc
Publication of US20080275458A1 publication Critical patent/US20080275458A1/en
Assigned to BAXANO, INC. reassignment BAXANO, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BLEICH, JEFFERY L., BLEAM, JEFFEREY, LEGUIDLEGUID, ROY, SCHMITZ, GREGORY P.
Priority to US12/816,729 priority patent/US20100331883A1/en
Priority to US12/984,162 priority patent/US9247952B2/en
Priority to US13/588,969 priority patent/US8568416B2/en
Publication of US8257356B2 publication Critical patent/US8257356B2/en
Application granted granted Critical
Priority to US13/757,599 priority patent/US9125682B2/en
Priority to US14/064,085 priority patent/US9320618B2/en
Assigned to BAXANO SURGICAL, INC. reassignment BAXANO SURGICAL, INC. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: BAXANO, INC.
Assigned to QUANDARY MEDICAL, LLC reassignment QUANDARY MEDICAL, LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BAXANO SURGICAL, INC
Assigned to EXWORKS CAPITAL FUND I, L.P. reassignment EXWORKS CAPITAL FUND I, L.P. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BAXANO SURGICAL, INC.
Assigned to AMENDIA, INC. reassignment AMENDIA, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: EXWORKS CAPITAL FUND I, L.P.
Priority to US14/816,813 priority patent/US9492151B2/en
Priority to US14/969,691 priority patent/US9463041B2/en
Assigned to ANTARES CAPITAL LP, AS AGENT reassignment ANTARES CAPITAL LP, AS AGENT SECURITY INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: AMENDIA, INC.
Assigned to CORTLAND CAPITAL MARKET SERVICES LLC, AS AGENT reassignment CORTLAND CAPITAL MARKET SERVICES LLC, AS AGENT SECURITY INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: AMENDIA, INC.
Assigned to MIS IP HOLDINGS LLC reassignment MIS IP HOLDINGS LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: QUANDARY MEDICAL LLC
Assigned to AMENDIA, INC. reassignment AMENDIA, INC. ASSIGNMENT CORRECTION UNDER MPEP 323.01(C) AT REEL 034954 FRAME 0526. Assignors: AMENDIA, INC.
Assigned to SCHELL, JEFFREY reassignment SCHELL, JEFFREY SECURITY INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: QUANDARY MEDICAL LLC
Assigned to SPINAL ELEMENTS, INC. reassignment SPINAL ELEMENTS, INC. MERGER AND CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: AMENDIA, INC., SPINAL ELEMENTS, INC.
Active legal-status Critical Current
Adjusted expiration legal-status Critical

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320016Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320016Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32053Punch like cutting instruments, e.g. using a cylindrical or oval knife
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3401Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3494Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
    • A61B17/3496Protecting sleeves or inner probes; Retractable tips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1487Trocar-like, i.e. devices producing an enlarged transcutaneous opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/04Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • A61M25/09041Mechanisms for insertion of guide wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • A61M25/0905Guide wires extendable, e.g. mechanisms for extension
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320708Curettes, e.g. hollow scraping instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1477Needle-like probes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00261Discectomy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00287Bags for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00349Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00469Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for insertion of instruments, e.g. guide wire, optical fibre
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477Coupling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320004Surgical cutting instruments abrasive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320044Blunt dissectors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/32006Surgical cutting instruments with a cutting strip, band or chain, e.g. like a chainsaw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1425Needle
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/061Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0801Prevention of accidental cutting or pricking
    • A61B2090/08021Prevention of accidental cutting or pricking of the patient or his organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056Transvascular endocardial electrode systems
    • A61N1/057Anchoring means; Means for fixing the head inside the heart
    • A61N2001/0578Anchoring means; Means for fixing the head inside the heart having means for removal or extraction

Definitions

  • 60/681,864 filed May 16, 2005, titled “Methods and Apparatus for Selective Surgical Removal of Tissue”
  • the devices, methods and systems described herein relate generally to medical/surgical devices and methods. More specifically, they may relate to guidewire systems and methods for advancing one or more surgical devices between tissues in a patient.
  • less invasive surgical techniques have become increasingly more popular, as physicians, patients and medical device innovators have sought to achieve similar or improved outcomes, relative to conventional surgery, while reducing the trauma, recovery time and side effects typically associated with conventional surgery.
  • Developing less invasive surgical methods and devices can pose many challenges. For example, some challenges of less invasive techniques include working in a smaller operating field, working with smaller devices, and trying to operate with reduced or even no direct visualization of the structure (or structures) being treated. These challenges are compounded by the fact that target tissues to be modified often reside very close to one or more vital, non-target tissues, which the surgeon hopes not to damage.
  • One of the initial obstacles in any given minimally invasive procedure therefore, is positioning a minimally invasive surgical device in a desired location within the patient to perform the procedure on one or more target tissues, while avoiding damage to nearby non-target tissues.
  • less invasive surgical procedures include laparoscopic procedures, arthroscopic procedures, and minimally invasive approaches to spinal surgery, such as a number of less invasive intervertebral disc removal, repair and replacement techniques.
  • spinal stenosis occurs when neural and/or neurovascular tissue in the spine becomes impinged by one or more structures pressing against them, causing one or more symptoms. This impingement of tissue may occur in one or more of several different areas in the spine, such as in the central spinal canal, or more commonly in the lateral recesses of the spinal canal and/or one or more intervertebral foramina.
  • FIGS. 1-3 show various partial views of the lower (lumbar) region of the spine.
  • FIG. 1 shows an approximate top view of a vertebra with the cauda equina (the bundle of nerves that extends from the base of the spinal cord through the central spinal canal) shown in cross section and two nerve roots exiting the central spinal canal and extending through intervertebral foramina on either side of the vertebra.
  • the spinal cord and cauda equina run vertically along the spine through the central spinal canal, while nerve roots branch off of the spinal cord and cauda equina between adjacent vertebrae and extend through the intervertebral foramina.
  • Intervertebral foramina may also be seen in FIGS. 2 and 3 , and nerves extending through the foramina may be seen in FIG. 2 .
  • FIG. 1 One common cause of spinal stenosis is buckling and thickening of the ligamentum flavum (one of the ligaments attached to and connecting the vertebrae), as shown in FIG. 1 .
  • Normal ligamentum flavum is shown in cross section in FIG. 3
  • Buckling or thickening of the ligamentum flavum may impinge on one or more neurovascular structures, dorsal root ganglia, nerve roots and/or the spinal cord itself.
  • Another common cause of neural and neurovascular impingement in the spine is hypertrophy of one or more facet joints (or “zygopophaseal joints”), which provide articulation between adjacent vertebrae.
  • facet joints or “zygopophaseal joints”
  • Each superior articular process articulates with an inferior articular process of an adjacent vertebra to form a zygopophaseal joint.
  • a joint is labeled in FIG. 3 .
  • Other causes of spinal stenosis include formation of osteophytes (or “bone spurs”) on vertebrae, spondylolisthesis (sliding of one vertebra relative to an adjacent vertebra), facet joint synovial cysts, and collapse, bulging or herniation of an intervertebral disc into the central spinal canal.
  • Disc, bone, ligament or other tissue may impinge on the spinal cord, the cauda equina, branching spinal nerve roots and/or blood vessels in the spine to cause loss of function, ischemia and even permanent damage of neural or neurovascular tissue. In a patient, this may manifest as pain, impaired sensation and/or loss of strength or mobility.
  • spinal stenosis occurs with an incidence of between 4% and 6% of adults aged 50 and older and is the most frequent reason cited for back surgery in patients aged 60 and older.
  • Conservative approaches to the treatment of symptoms of spinal stenosis include systemic medications and physical therapy. Epidural steroid injections may also be utilized, but they do not provide long lasting benefits. When these approaches are inadequate, current treatment for spinal stenosis is generally limited to invasive surgical procedures to remove ligament, cartilage, bone spurs, synovial cysts, cartilage, and bone to provide increased room for neural and neurovascular tissue.
  • the standard surgical procedure for spinal stenosis treatment includes laminectomy (complete removal of the lamina (see FIGS.
  • Described herein are devices, systems and method for positioning, actuating and exchanging various tissue access, treatment, and localization devices.
  • described herein are exchange systems using a guidewire which may be used to both position and/or actuate a variety of such devices, while allowing exchange of such devices.
  • Systems including these guidewires may be referred to herein as “exchange systems”, “guidewire systems,” “guidewire exchange systems” or the like.
  • methods of exchanging a surgical device while treating a patient may include the steps of advancing a guidewire at least partially around a target tissue in a patient so that the proximal end of the guidewire extends from a first site on the patient and the distal end of the guidewire extends from a second site on the patient, coupling the proximal end of the guidewire on or near the distal end of a first surgical device, positioning the first surgical device by pulling the distal end of the guidewire, de-coupling the proximal end of the guidewire from the first surgical device, coupling the proximal end of the guidewire to a second surgical device, and positioning the second surgical device by pulling the distal end of the guidewire.
  • the method may also include the step of withdrawing the first surgical device from the patient by pulling on the proximal end of the first surgical device.
  • the surgical device may be a relatively elongate device having a flexible distal end.
  • the distal region of the device is preferably low-profile, and may be flat or thin.
  • Surgical devices appropriate for use with the methods and systems described herein may be pulled into the subject using the guidewire, so that the proximal end of the surgical device (or a connector connected to the proximal end) remains outside of the patient.
  • the first surgical device comprises an elongate surgical device having a flexible distal end.
  • the surgical device may be a tissue modification device (e.g., having a surface including one or more tissue modification elements).
  • the method may also include the step of urging the first surgical device against the target tissue by applying tension to either or both of the first surgical device extending from the first site and the guidewire extending from the second site.
  • the method may also include the step of urging the second surgical device against the target tissue by applying tension to either or both of the second surgical device extending from the first site and the guidewire extending from the second site.
  • the step of advancing the guidewire may include advancing the guidewire through a spinal foramen, particularly an intervertebral foramen.
  • Neural tissue localization may also be included as a part of the methods described herein. It may be particularly beneficial to confirm that neural tissue (e.g., a nerve) is not located between the target tissue and the guidewire before performing a procedure on the target tissue. Any appropriate tissue localization step may be used. For example, the tissue adjacent to the pathway of the guidewire may be directly visualized (using an endoscope, etc.), or indirectly visualized (using a medical imaging technology). Electrical tissue stimulation may be used. Examples of tissue localization methods, devices and systems that may be used can be found in U.S.
  • an electrical current is applied to the tissue adjacent the pathway of the guidewire to stimulate a nerve. Stimulation can be detected (e.g., by muscle twitch, EMG, etc.).
  • the step of advancing the guidewire may include the step of confirming that a non-target nerve is not between the target tissue and the path of the guidewire, and in some variations the step of confirming that a non-target nerve is not between the target tissue and the path of the guidewire comprises applying electrical energy to the tissue.
  • Also described herein are methods of exchanging a surgical device while treating a patient that include the steps of: advancing a guidewire through an intervertebral foramen and at least partially around a target tissue in a patient so that the proximal end of the guidewire extends from a first site on the patient and the distal end of the guidewire extends from a second site on the patient, coupling the proximal end of the guidewire on or near the distal end of a first surgical device, pulling the distal end of the guidewire to position the first surgical device adjacent the target tissue, removing the first surgical device from the patient while leaving the guidewire in the patient, de-coupling the proximal end of the guidewire from the first surgical device, coupling the proximal end of the guidewire to a second surgical device, and pulling the distal end of the guidewire to position the second surgical device.
  • Also described herein are methods of treating a patient including the step of advancing a distal end of a guidewire into the patient's body from a first site, advancing the distal end at least partially around a target tissue, extending the distal end of the guidewire out of the body from a second site, while maintaining a proximal end of the guidewire outside the body at the first site, coupling the proximal end of the guidewire on or near a distal end of a surgical device, and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position adjacent to the target tissue.
  • the guidewire is inserted through the patient's body so that both the proximal and distal ends of the guidewire extend from the body, typically (but not necessarily) from separate entry and exit sites.
  • the path that the guidewire takes is curved or bent, and the bend occurs adjacent to the target tissue.
  • This may allow the guidewire or a device attached to the guidewire to be urged specifically against the target tissue by applying tension.
  • one or both ends of the guidewire (or a device attached to the guidewire) may be pulled, urging the device against the target tissue.
  • the method may include the step of urging the surgical device against the target tissue by applying tension to either or both of the surgical device extending from the first site and the guidewire extending from the second site.
  • the step of coupling the proximal end of the guidewire on or near the distal end of the surgical device may include coupling the proximal end of the guidewire to the surgical device with at least one coupling member.
  • the step may include engaging a guidewire coupling member on the surgical device with the distal end of the guidewire.
  • the method also includes the step of locking the proximal end of the guidewire on or near a distal end of a surgical device.
  • the guidewire may be permanently or releasably locked to the surgical device.
  • the guidewire may be permanently locked by crimping the coupling member or be lodging the guidewire (e.g., the shaped proximal end of the guidewire) within the coupling member of the surgical device.
  • the method may also include the step of performing a surgical procedure on the target tissue using the surgical device.
  • the step of performing a surgical procedure may include reciprocating the surgical device by pulling on either or both of the surgical device extending from the first site and the guidewire extending from the second site.
  • the method may also include the step of withdrawing the surgical device proximally from the patient.
  • the method also includes de-coupling the proximal end of the guidewire from the surgical device and coupling the proximal end of the guidewire on or near a distal end of a second surgical device.
  • Also described herein are methods for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body may include the steps of: advancing a distal end of a guidewire into the patient's body, between two tissues, and out of the body, while maintaining a proximal end of the guidewire outside the body, coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a surgical device, and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues.
  • FIG. 1 is cross-sectional view of a spine, showing a top view of a lumbar vertebra, a cross-sectional view of the cauda equina, and two exiting nerve roots.
  • FIG. 2 is a left lateral view of the lumbar portion of a spine with sacrum and coccyx.
  • FIG. 3 is a left lateral view of a portion of the lumbar spine, showing only bone and ligament tissue and partially in cross section.
  • FIG. 4 is a cross-sectional view of a patient's back and spine with a side view of a guidewire and tissue modification system in place for performing a tissue removal procedure.
  • FIG. 6 is a cross-sectional view of a patient's back and spine and a side view of a rasp device and guidewire system.
  • FIGS. 5A-5I illustrate one variation of a method for advancing a tissue modifying device into a patient's body using a guidewire delivery system.
  • FIG. 7 is a cross-sectional view of a patient's back and spine and a side view of an ultrasound device and guidewire system.
  • FIG. 8A is a cross-sectional view of a patient's back and spine and a side view of a tissue access device with swappable tissue modification devices and a guidewire system.
  • FIGS. 8B-8M are side/perspective views of distal portions of a number of different devices which may be placed through/used with a tissue access device such as that shown in FIG. 8A .
  • FIG. 9 is a cross-sectional view of a patient's back and spine and a side view of a tissue access device with swappable tissue modification devices and a guidewire system.
  • FIG. 10 is a perspective view of a tissue access device coupled with a guidewire.
  • FIG. 11 is a perspective view of a tissue access device coupled with a guidewire.
  • FIG. 12 is a perspective view of a tissue access device coupled with a guidewire.
  • FIGS. 13A and 13C are perspective views, and FIGS. 13B and 13D are top views, of a distal end of a tissue modification device with guidewire coupling member and a shaped guidewire.
  • FIGS. 14A and 14B are perspective views of a distal end of a tissue modification device with guidewire coupling member and a shaped guidewire.
  • FIGS. 15A and 15C are perspective views of a guidewire coupling member and a shaped guidewire, demonstrating a method for coupling the two.
  • FIGS. 15B and 15D are top views of the guidewire coupling member and shape guidewire of FIGS. 15A and 15C .
  • FIGS. 15E and 15F are different perspective views of the guidewire coupling member of FIGS. 15A and 15C , without the shaped guidewire.
  • FIGS. 16A-16C are perspective, top and side views, respectively, of a guidewire coupling member.
  • FIGS. 16D and 16E are top views of the guidewire coupling member of FIGS. 16A-16C and a shaped guidewire, demonstrating a method for coupling the coupling member with a shaped guidewire.
  • FIGS. 17A and 17B are perspective views of a guidewire coupling member.
  • FIGS. 17C and 17D are top views of the guidewire coupling member of FIGS. 17A and 17B and a shaped guidewire, demonstrating a method for coupling the coupling member with the guidewire.
  • FIGS. 18A and 18B are top views of a single-cam guidewire coupling member.
  • FIG. 19 is a top view of a double-cam guidewire coupling member.
  • FIGS. 20A-20C are top views of a movable-piece guidewire coupling member.
  • FIG. 21A is a perspective view
  • FIGS. 21B and 21C are side cross-sectional views, of a split-cone guidewire coupling member.
  • FIG. 22 is a top view of a flat anvil guidewire coupling member.
  • FIG. 23 is a top view of a corner pinch guidewire coupling member.
  • FIG. 24 is a top view of an eccentric cam guidewire coupling member.
  • FIGS. 25A and 25B are perspective views of a hooked guidewire and receiving guidewire coupling member.
  • FIGS. 26A and 26B are perspective views of a ball-and-socket guidewire and guidewire coupling member.
  • FIGS. 27A and 27B are top and perspective views, respectively, of a spool trap guidewire coupling member.
  • FIGS. 28A and 28B are side views of a semicircular ribbon guidewire coupling member with textured guidewire.
  • FIG. 29 is a side view of a folded ribbon guidewire coupling member with textured guidewire.
  • FIG. 30 is a side view of a ribbon guidewire coupling member.
  • FIG. 31 is a side view of a multi-point guidewire coupling member.
  • FIG. 32 is a side view of a rough-surface guidewire coupling member.
  • FIGS. 33A-33D are side views of proximal and distal ends of various guidewires.
  • FIG. 34A is a perspective view of a drill-shaped distal end of a guidewire.
  • FIG. 34B is a side view of a guidewire as in FIG. 34A , being passed through a probe device.
  • FIGS. 35A and 35B are perspective and exploded views of a handle for grasping a guidewire.
  • FIGS. 36A to 36C illustrate one method of exchanging a device using a positioned guidewire.
  • FIG. 37 shows a perspective view of one variation of an exchange system.
  • FIGS. 38A and 38B illustrate locking of the exchange system of FIG. 37 .
  • FIG. 38C is a cross-section through the system shown in FIG. 37 , showing exemplary dimensions.
  • FIG. 39A is a perspective view of another variation of an exchange system.
  • FIGS. 39B and 39C illustrate locking of the exchange system of FIG. 39A .
  • FIG. 39D is a cross-section through the system shown in FIG. 39A , showing exemplary dimensions.
  • FIG. 40A is a perspective view of another variation of an exchange system.
  • FIG. 40B illustrates locking of the exchange system of FIG. 40A .
  • FIG. 40C shows a perspective view of one of the coupling members shown in FIG. 40A .
  • FIG. 41A is perspective view of a locking exchange system.
  • FIGS. 41B and 41C are cross-sectional views illustrating the operation of the exchange system shown in FIG. 41A .
  • FIGS. 42A-42C illustrate another locking exchange system.
  • FIGS. 43A-43B illustrate an exchange system including a threaded coupling region.
  • FIGS. 44A-44C illustrate operation of a locking exchange system.
  • FIG. 45A is a perspective view of an exchange system
  • FIG. 45B is a cross-section of the exchange system shown in FIG. 45A .
  • FIG. 45C shows one variation of a locking portion in a coupling member of the exchange system shown in FIG. 45A .
  • the guidewire systems described herein includes a guidewire and at least one surgical device that are configured so that the proximal end of the guidewire couples to the distal end of the guidewire.
  • the guidewire typically has a distal end that is configured to extend from a subject's body and be manipulated, and a proximal end that includes a coupling member for coupling to the surgical device.
  • the coupling member may be referred to as a device coupling member and may be located at or near the proximal end of the guidewire. Any appropriate surgical device or devices may be included as part of the guidewire system.
  • the surgical device typically includes a coupling member on or near its distal end that is configured to mate with the coupling member on or near the proximal end of the guidewire.
  • the device-side coupling member may be referred to as a guidewire coupling member.
  • a guidewire system and method for positioning one or more surgical devices in a patient are provided. Although the following description and accompanying drawing figures generally focus on positioning various surgical devices in a spine, in alternative embodiments, guidewire systems and methods of the present invention may be used to position any of a number of devices in other anatomical locations in a patient's body.
  • FIG. 4 one embodiment of a guidewire system 10 is shown coupled with a tissue cutting device 11 in position within a patient's spine. Further description of various embodiments of cutting device 11 may be found in U.S. patent application Ser. No. 11/461,740, entitled “Multi-Wire Tissue Cutter”, and filed Aug. 1, 2006, the full disclosure of which is hereby incorporated by reference. A number of alternative embodiments of cutting devices, many of which may be used (or adapted for use) with guidewire system 10 , are further described in U.S. patent application Ser. No. 11/375,265, entitled “Methods and Apparatus for Tissue Modification”, and filed Mar. 13, 2006; Ser. No.
  • tissue cutting device 11 may include a shaft 12 , a proximal handle 16 , a flexible distal portion 13 , two or more cutting blades 26 and a guidewire coupling member 30 .
  • Guidewire system 10 may include a guidewire 32 having a sharpened tip 33 (often referred to herein as the “sharpened distal tip”) for facilitating advancement of guidewire 32 through tissue.
  • guidewire 32 may also include a device coupling member that is configured as a shaped member (not visible in FIG. 4 ) at the end opposite sharpened tip 33 (often referred to herein as the guidewire “proximal end”) for coupling with coupling member 30 .
  • Guidewire system 10 may also include a guidewire handle 34 (or “distal handle”) for coupling with guidewire 32 , which in some cases may include a tightening member 36 for securing a portion of guidewire 32 within guidewire handle 34 .
  • cutting device 11 may be advanced into a patient's back through an incision 20 , which is shown in FIG. 4 as an open incision but which may be a minimally invasive or less invasive incision in alternative embodiments.
  • device 11 may be advanced by coupling guidewire connector 30 with guidewire 32 that has been advanced between target and non-target tissues, and then pulling guidewire 32 to pull device 11 between the tissues.
  • guidewire system 10 may be used to pull flexible distal portion 13 into place between tissues in hard-to-reach or tortuous areas of the body, such as between a nerve root (NR) and facet joint and through an intervertebral foramen (IF).
  • NR nerve root
  • IF intervertebral foramen
  • flexible portion 13 may be advanced to a position such that blades 26 face tissue to be cut in a tissue removal procedure (“target tissue”) and a non-cutting surface (or surfaces) of flexible portion 13 faces non-target tissue, such as nerve and/or neurovascular tissue.
  • target tissue tissue removal procedure
  • blades 26 are positioned to cut ligamentum flavum (LF) and may also cut hypertrophied bone of the facet joint, such as the superior articular process (SAP).
  • LF ligamentum flavum
  • SAP superior articular process
  • FIG. 4 More anatomical structures depicted in FIG. 4 include the vertebra (V) and cauda equina (CE)).
  • flexible portion 13 may be replaced with a curved, rigid portion, a steerable portion, a straight portion with a distal extension or the like.
  • the configuration, dimensions, flexibility, steerability, materials and the like of flexible portion 13 may be adjusted, in alternative embodiments, depending on a type of tissue or anatomical structure to be accessed or modified.
  • guidewire 32 Before or after blades 26 are located in a desired position, guidewire 32 may be removably coupled with guidewire handle 34 , such as by passing guidewire 32 through a central bore in handle 34 and moving tightening member 36 to secure a portion of guidewire 32 within handle 34 .
  • a physician (or two physicians or one physician and an assistant) may then pull on proximal handle 16 and distal handle 34 to apply tensioning force to guidewire 32 and cutting device 11 and to urge the cutting portion of device 11 against ligamentum flavum (LF), superior articular process (SAP), or other tissue to be cut.
  • Proximal handle 16 may then be actuated, such as by squeezing in the embodiment shown, to cause one or both blades 26 to move toward one another to cut tissue.
  • Proximal handle 16 may be released and squeezed as many times as desired to remove a desired amount of tissue.
  • guidewire 32 may be released from distal handle 34 , and cutter device 11 and guidewire 32 may be removed from the patient's back.
  • FIGS. 5A-51 one embodiment of a method for advancing a tissue modifying device into a patient's body using a guidewire delivery system is shown.
  • this method is shown in reference to placement of a device in a spine, in various alternative embodiments, such a method may be used to place similar or alternative tissue modification devices in other locations in a human body, such as between tissues in a joint space, in the abdominal cavity, or in the carpal tunnel of the wrist, between bone and soft tissue in other parts of the body, and the like.
  • a probe 40 may be inserted into a patient's back using an open technique facilitated by retractors 42 .
  • Target tissues of a procedure may include ligamentum flavum (LF) and/or facet joint (F) tissue of a vertebra (V), which may impinge on non-target tissues, such as nerve root (NR) and/or cauda equina (CE), of the lumbar spine.
  • LF ligamentum flavum
  • F facet joint
  • V tissue of a vertebra
  • NR nerve root
  • CE cauda equina
  • D intervertebral disc
  • a curved distal portion of probe 40 has been advanced to a position between target ligamentum flavum (LF) and non-target nerve root (NR) tissues.
  • a curved guide member 46 may next be advanced out of an aperture on the curved distal portion of probe 40 .
  • guide member 46 may be housed within probe and advanced out of the distal aperture by advancing a slide member 44 on the shaft of probe 40 .
  • guidewire 32 may be advanced through guide member 46 and out of the patient's back, using sharpened tip 33 to facilitate passage through the patient's back tissue. Probe 40 may then be removed, as shown in FIG.
  • FIG. 5E leaving guidewire 32 in place between the target and non-target tissues, as shown in FIG. 5F .
  • a shaped member 50 in this embodiment, a ball
  • the curved distal portion of probe 40 , curved guide member 46 , or both may include one, two or more electrodes to help locate nerve tissue before placing guidewire 32 .
  • Such neural localization helps ensure that guidewire 32 is positioned between target and non-target tissue, which in turn helps ensure that a tissue modification device (or devices) placed using guidewire 32 are oriented so that a tissue modifying portion (or portions) of the device face and act on target tissue and not on non-target tissue such as neural tissue.
  • Tissue modification device 52 may include a proximal handle 54 , a rigid proximal shaft portion 56 , a flexible distal shaft portion 58 , tissue cutting blades 60 , and coupling member 62 .
  • Coupling member 62 various embodiments of which are described in greater detail below, may be either attached to or formed in distal shaft portion 58 . In some embodiments, such as the one depicted in FIG.
  • guidewire 32 may be laid into a channel on coupling member 62 , and guidewire 32 and/or distal portion 58 may be rotated, relative to one another, to lock shaped member 50 into coupling member.
  • guidewire 32 and tissue modification device 52 may also be coupled with distal guidewire handle 34 , such as by advancing distal handle 34 over guidewire 32 (solid-tipped arrow).
  • tightening member 36 may next be moved (curved, solid-tipped arrow) to tighten distal handle 34 around guidewire 32 .
  • Distal handle 34 may then be pulled (straight, solid-tipped arrow) to pull guidewire 32 and thus advance distal shaft portion 58 of tissue modification device 52 into place between target and non-target tissues in the spine, as shown in FIG. 5I .
  • proximal handle 54 and distal handle 34 may be pulled (straight, solid-tipped arrows), to apply tensioning force to guidewire 32 and device 52 and thus urge flexible portion 58 and blades 60 against target tissue, such as ligamentum flavum (LF) and/or facet joint (F) tissue.
  • Handle 54 may then be actuated (curved, double-tipped arrow) to cause blades 60 to cut target tissue.
  • guidewire 32 may be released from distal handle 34 , and tissue modification device 52 and guidewire 32 may be removed from the patient's back.
  • the guidewire may be left at least partially in the body so that it can be used to position and/or actuate other surgical device. This method for advancing tissue modification device 52 using guidewire 32 is but one exemplary embodiment.
  • probe 40 and tissue modification device 52 may be combined into one device.
  • Such a device may include a guidewire lumen through which guidewire 32 may be passed.
  • the combined device may be partially inserted into a patient, and guidewire 32 advanced between target and non-target tissues through the guidewire lumen.
  • Shaped member 50 (device coupling member) of guidewire 32 may then catch on one or more coupling members 62 of the combined device (guidewire coupling member), to allow the device to be pulled into position between the target and non-target tissues.
  • Guidewire 32 may then further be used to help apply tensioning force to the device to urge an active portion against target tissues.
  • access to the intervertebral foramen may be achieved using a lateral approach, rather than a medial approach.
  • guidewire system 10 is shown with an alternative embodiment including a tissue modification device 64 , which may include a proximal handle 66 , a rigid proximal shaft portion 68 , and a distal flexible shaft portion 70 .
  • tissue modification device 64 may include a proximal handle 66 , a rigid proximal shaft portion 68 , and a distal flexible shaft portion 70 .
  • Multiple abrasive members 72 and a guidewire coupling member 74 may be coupled with one side of flexible shaft portion 70 .
  • guidewire 32 may be coupled with coupling member 74 and used to pull distal shaft portion 70 of modification device 64 into place between target and non-target tissues.
  • Proximal handle 66 and distal handle 34 may then be pulled/tensioned (solid-tipped arrows) to urge abrasive members 72 against the target tissue, and handles 66 , 34 may further be used to reciprocate device 64 and guidewire 32 back and forth (hollow/double-tipped arrows) to modify the target tissue. Reciprocation and tensioning may be continued until a desired amount of tissue is removed, at which point guidewire 32 may be released from distal handle 34 , and device 64 and guidewire 32 may be removed from the patient's back.
  • tissue modification device 64 may include any of a number of abrasive members 72 , abrasive materials, or the like, which may be arrayed along distal shaft portion 70 for any desired length and in any desired configuration. Further examples of abrasive members 70 , materials, surfaces and the like are described in U.S. patent application Ser. No. 11/429,377, which was previously incorporated by reference.
  • shaft portions 68 , 70 may both be rigid or may both be flexible and may have different cross-sectional shapes or the same shape.
  • an ultrasound tissue modification device 76 may be advanced into position in a patient's back using guidewire system 10 .
  • ultrasound device 76 may include a proximal handle 78 , a hollow shaft 80 having a distal window 81 , multiple ultrasound wires 82 extending through shaft 80 and into window 81 , a guidewire connector 84 coupled with a tapered distal end of shaft 80 , an ultrasound generator 88 , and a wire 86 coupling handle 78 with generator 88 .
  • Handle 78 may include, for example, an ultrasound transducer, horn and/or other ultrasound transmission components.
  • Shaft 80 may be completely rigid, completely flexible, or part rigid/part flexible, according to various embodiments.
  • Ultrasound energy provided by generator 88 may be converted in handle 78 to reciprocating motion of wires 82 , and reciprocating wires 82 may be used to cut, chisel or otherwise modify soft and/or hard tissues. Further description of such an embodiment is provided in U.S. patent application Ser. No. 11/461,740, which was previously incorporated by reference.
  • Guidewire connector 84 may comprise one of a number of different connectors, various embodiments of which are described in further detail below.
  • guidewire system 10 may be used to pull/advance a tissue access device 90 into place between target and non-target tissues.
  • Tissue access device 90 may include a proximal handle 92 , a hollow shaft 94 having a distal curved portion with a distal window 96 , and a guidewire connector 98 coupled with a tapered distal end of shaft 94 .
  • shaft 94 may be flexible along its entire length, rigid along its entire length, or rigid in part and flexible in part, and may be made of any suitable material or combination of materials.
  • shaft 94 may also be steerable, such as with one or more pull wires or other steering mechanisms, for example to steer or curve a distal portion of shaft 94 .
  • any of a number of compatible tissue modification devices 100 , 101 , 104 or other devices may be advanced through access device 90 to perform a tissue modification procedure or other functions.
  • Such devices may swappable in and out of access device 90 and may be in the form of cartridges, so that various cartridges may be inserted and removed as desired, over the course of a procedure. Examples of several tissue modification devices are shown in FIG.
  • FIGS. 8A-8M including a rongeur device 100 , an ultrasound device 101 (including wire 102 and ultrasound generator 103 ), and an abrasive, reciprocating device 104 . Further examples of tissue modification and other devices are described below with reference to FIGS. 8B-8M .
  • each tissue modification device 100 , 101 , 104 may be flexible, and a proximal portion of each modification device 100 , 101 , 104 may have a locking feature for locking into proximal handle 92 of access device 90 .
  • a given modification device such as abrasive device 104
  • a user may then grasp handles 34 and 92 , pull up to urge abrasive members 105 against target tissue, and reciprocate access device 90 and guidewire system 10 back and forth to remove target tissue.
  • the user may then choose to remove abrasive device 104 and insert one of the other devices 100 , 101 to further modify target tissues.
  • any of a number of tissue modification devices and/or other devices may be provided (for example as cartridges) for used with access device 90 .
  • one or more of such devices may be provided with access device 90 and guidewire device 10 as a system or kit.
  • Any given tissue modification device may act on tissue in a number of different ways, such as by cutting, ablating, dissecting, repairing, reducing blood flow in, shrinking, shaving, burring, biting, remodeling, biopsying, debriding, lysing, debulking, sanding, filing, planing, heating, cooling, vaporizing, delivering a drug to, and/or retracting target tissue.
  • Non-tissue-modifying devices or cartridges may additionally or alternatively be provided, such as but not limited to devices for: capturing, storing and/or removing tissue; delivering a material such as bone wax or a pharmacologic agent such as thrombin, NSAID, local anesthetic or opioid; delivering an implant; placing a rivet, staple or similar device for retracting tissue; delivering a tissue dressing; cooling or freezing tissue for analgesia or to change the tissue's modulus of elasticity to facilitate tissue modification; visualizing tissue; and/or diagnosing, such as by using ultrasound, MRI, reflectance spectroscopy or the like.
  • any combination of tissue modification and/or non-tissue-modifying devices may be used with access device 90 .
  • tissue modification devices and/or other devices for used with an access device 90
  • these devices may also be used without an access device 90 .
  • a surgical device may be coupled to a guidewire and inserted (via a percuateous or open route) into a patient using the guidewire without the use of an additional access device 90 .
  • the surgical devices used as part of the guidewire systems have a relatively flat and flexible distal end region.
  • FIGS. 8B-8M distal portions of a number of exemplary embodiments of surgical devices (which may be in cartridge form in some embodiments and may be used with access device 90 ) are shown.
  • FIG. 8B shows a device 430 including a sharpened, pointed, double-beveled distal tip 432 . Tip 432 may be advanced across window 96 of access device 90 to cut tissue.
  • FIG. 8C shows a device 440 including a diagonal-edge distal cutting tip 442 , which may be used in a similar manner to cut tissue.
  • FIG. 8D shows a device 450 including multiple volcano-shaped abrasive members 452 . In alternative embodiments of abrasive devices, any suitable abrasive members or surfaces may be used.
  • FIG. 8B shows a device 430 including a sharpened, pointed, double-beveled distal tip 432 . Tip 432 may be advanced across window 96 of access device 90 to cut tissue.
  • FIG. 8C shows a device 440 including
  • FIG. 8E shows a device 460 including a portion of a Gigli saw 462 attached to the device's upper surface, such as by welding. Any of a number of blades may alternatively be attached to a device, such as in the device 470 shown in FIG. 8F .
  • device 470 includes a proximally placed blade 472 having a cutting edge 474 , which may be advanced across window 96 to cut tissue.
  • FIG. 8G shows an alternative embodiment in which a device 480 includes a distally placed blade 482 with a cutting edge 484 that may be drawn back/retracted across window 96 to cut tissue.
  • FIG. 8H shows a device 490 including a radiofrequency (RF) loop electrode 492 for cutting tissue and extending proximally via two insulated wires 494 .
  • RF radiofrequency
  • a device 500 may include a side-facing aperture 502 and a chamber 504 .
  • Device 500 may be advanced into access device 90 to align aperture 502 with window 96 and may then be used to collect tissue in chamber 504 .
  • Device 500 may then be removed (in some variations through access device 90 ) to remove the tissue from the patient. This may be repeated as many times as desired, to remove cut tissue from the patient.
  • FIG. 8J shows a device 510 having a clamp 512 for delivering an implant 514 .
  • Implant 514 for example, may be a posterior decompression implant such as the “X-STOP” Interspinous Process DecompressionTM devices offered by St. Francis Medical Technologies, Inc.
  • FIG. 8K shows an embodiment of a device 520 used for delivering a rivet (or “tissue anchor”) 524 through a distal aperture 522 .
  • tissue anchor 524 may be anchored to bone and used to retract ligamentum flavum tissue to increase the area of a space in the spine.
  • tissue anchor 524 is described in more detail, for example in U.S. patent application Ser. No. 11/250,332, entitled “Devices and Methods for Selective Surgical Removal of Tissue,” and filed Oct. 15, 2004, the full disclosure of which is hereby incorporated by reference.
  • a visualization device 530 having a visualization element 532 may be used with access device 90 .
  • a device may include, for example, an endoscope, fiber optics, a camera coupled with a catheter or the like.
  • ultrasound, MRI, spectroscopy or other diagnostic or visualization devices may be used.
  • FIG. 8M shows an alternative embodiment of a device 540 , which includes a distal aperture 542 through which a tissue dressing 544 may be delivered.
  • Tissue dressing 544 may include one or more fabrics, gel foam or the like.
  • one or more pharmacologic agents may be delivered through device 540 .
  • irrigation and/or suction may be provided through device 540 .
  • any suitable device, cartridge or combination of devices/cartridges may be used either with access device 90 or without a separate access device. These devices may be positioned and/or manipulated (e.g., urged against a target tissue) using the guidewire systems described herein. In addition, multiple devices may be exchanged during a procedure using the same guidewire.
  • Tissue access device 106 may include, for example, a proximal handle 107 having a hollow bore 108 and an actuator 109 , a hollow shaft 110 extending from proximal handle 107 and having a distal curved portion and a distal window 112 , and a guidewire coupling member 114 coupled with a tapered distal end of shaft 110 .
  • tissue modification devices 116 , 117 , 120 may be inserted and removed from access device 106 to perform a tissue modification procedure, such as a rongeur 116 , an ultrasound device 117 (including a wire 118 and generator 119 ), and an abrasive device 120 .
  • a tissue modification procedure such as a rongeur 116 , an ultrasound device 117 (including a wire 118 and generator 119 ), and an abrasive device 120 .
  • handle 107 includes the additional feature of actuator 109 , which may be used to activate one or more tissue modifying members of various tissue modification devices.
  • rongeur 116 may be advanced into hollow bore 108 and shaft 110 , to position blades 121 of rongeur 116 so as to be exposed through window 112 , and to lock a locking member 115 of rongeur 116 within handle 107 .
  • Actuator 109 may then be moved back and forth (by squeezing and releasing, in the embodiment shown) to move one or both blades 121 back and forth to cut target tissue.
  • rongeur 116 may then be removed from access device 106 and a different modification device 117 , 120 inserted to further modify target tissue.
  • Actuator 109 may be used with some modification devices and not others.
  • access device 106 , guidewire system 10 and one or more modification devices 116 , 117 , 120 may be provided as a system or kit.
  • Device 240 may include an elongate, hollow shaft 242 having a distal aperture 244 , a distal extension 246 (or “platform” or “tissue shield”) extending beyond shaft 242 , and a guidewire coupling member 250 attached to distal extension 246 for coupling with a guidewire 252 .
  • Both shaft 242 and distal extension 246 may be either rigid or flexible, in various embodiments.
  • distal extension 246 includes multiple flexibility slits 248 to enhance flexibility of that portion of device 240 .
  • Shaft 242 , distal extension 246 and guidewire coupling member 250 may be made of any suitable material (or materials), and may be made from one piece of material as a single extrusion or from separate pieces attached together, in alternative embodiments. Suitable materials include, for example, metals, polymers, ceramics, or composites thereof.
  • Suitable metals may include, but are not limited to, stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, ElgiloyTM (Elgin Specialty Metals, Elgin, Ill., USA), ConichromeTM (Carpenter Technology, Reading, Pa., USA), or PhynoxTM (Imphy SA, Paris, France).
  • Suitable polymers include, but are not limited to, nylon, polyester, DacronTM, polyethylene, acetal, DelrinTM (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Ceramics may include, but are not limited to, aluminas, zirconias, and carbides.
  • tissue access device 240 may have any desired combination of dimensions and shapes.
  • shaft 242 and distal extension 246 have different cross-sectional shapes, while in other embodiments, they may have the same cross-sectional shape.
  • Some embodiments may include additional features, such as a mechanism for changing distal extension 246 from a straight configuration to a curved configuration (such as with one or more pull wires).
  • tissue access device 240 Any of a number of different surgical/tissue modification devices, such as but not limited to those described in reference to FIGS. 8 and 9 , may be used in conjunction with tissue access device 240 .
  • tissue modification device may be used, for example, by passing the device through shaft 242 , such that a portion of the device extends out of aperture 244 to perform a procedure, while distal extension 246 protects non-target tissue from harm.
  • multiple surgical devices may be passed through and used with tissue access device 240 , either serially or simultaneously, depending on the configuration of access device 240 and the constraints of the operating field and anatomy.
  • a tissue access device 260 includes an elongate, hollow shaft 262 , a handle 264 , a distal aperture 266 , and a distal extension 270 having flexibility slits 268 and coupled with a guidewire coupling member 272 , which may be coupled with a guidewire 274 .
  • This embodiment of tissue access device 260 is similar to the one described immediately above but includes the additional feature of handle 264 , which in some embodiments may be used to actuate one or more surgical/tissue modification devices passed through access device 260 .
  • FIG. 12 depicts another alternative embodiment of a tissue access device 280 , including a proximal shaft portion 282 , a distal shaft portion 286 , and a handle 284 .
  • Distal shaft portion 286 includes a window 288 , through which a portion of a surgical/tissue modification device may be exposed to perform a procedure, and a guidewire coupling member 290 , which may be coupled with a guidewire 292 .
  • any of a number of surgical devices may be passed through and used with tissue access device 280 , according to various embodiments.
  • Tissue modifying portions of such devices may be exposed through or may even extend out of window 288 to perform any of a number of procedures, while distal shaft portion 286 otherwise protects non-target tissue from damage.
  • shaft portions 282 , 286 may both be flexible, both be rigid, or one may be flexible and the other rigid.
  • shaft 282 , 286 may comprise a flexible catheter, while in an alternative embodiment, shaft 282 , 286 may comprise a rigid, probe-like structure.
  • any of the embodiments described in FIGS. 10-12 may further optionally include one or more external support devices, which removably attach to shaft 242 , 262 , 282 and one or more stabilizing structures outside the patient, such as a retractor, bed rail, or the like.
  • Such support devices such as detachable support arms, may be provided with a tissue access device 240 , 260 , 280 as part of a system or kit and may be used to help support/stabilize the access device during use.
  • a coupling member on (or near) the proximal end of a guidewire mates with the coupling member on (or near) the distal end of a surgical device.
  • the coupling members may be complimentary; for example, the device coupling member on the guidewire may be received by a guidewire coupling member on the device.
  • Coupling members may be configured to lock securely together. Coupling members may be configured so that reasonably high pulling forces (e.g., pulling on the distal end of the guidewire and/or the proximal end of the surgical device) can be handled without breaking or de-coupling the coupling members.
  • the coupling members are configured to lock together permanently or temporarily. For example, a coupling member may be configured to secure together until adequate force is applied to separate them.
  • Guidewire coupling member 130 may generally include a slit 131 and a bore 132 .
  • Guidewire 134 may include a device coupling member formed as a shaped member 136 at one end, which is shown as a ball-shaped member 136 but may have any of a number of suitable shapes in alternative embodiments.
  • guidewire 134 and shaped member 136 may be made of any suitable material, such as but not limited to any of a number of metals, polymers, ceramics, or composites thereof.
  • Suitable metals may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, ElgiloyTM (Elgin Specialty Metals, Elgin, Ill., USA), ConichromeTM (Carpenter Technology, Reading, Pa., USA), or PhynoxTM (Imphy SA, Paris, France).
  • Suitable polymers include but are not limited to nylon, polyester, DacronTM, polyethylene, acetal, DelrinTM (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK).
  • Ceramics may include but are not limited to aluminas, zirconias, and carbides.
  • Shaped member 136 may be formed by attaching a separate member to one end of guidewire 134 , such as by welding, or may be formed out of the guidewire material itself.
  • guidewire 134 may be coupled with coupling member 130 by first placing guidewire 134 through slit 131 into bore 132 , as shown in perspective view FIG. 13A and top view FIG. 13C .
  • Guidewire 134 may then be pulled through bore 132 (solid-tipped arrows in FIGS. 13A and 13C ), to pull shaped member 136 into bore 132 , as shown in perspective view FIG. 13B and top view FIG. 13D .
  • bore 132 may be tapered, so that shaped member 136 may enter bore 132 but may only travel partway through before reaching a diameter of bore 132 through which it cannot pass.
  • bore 132 may include a hard stop rather than a taper.
  • shaped member 136 may be pulled into bore 132 to cause it to lodge there, and additional pulling or tensioning force may be applied to guidewire 134 without risk of pulling shaped member 136 farther through bore 132 .
  • Guidewire 134 may thus be used to pull surgical device 138 through tissue and into a desired position for performing a procedure, and may further be used to apply tensioning/pulling force to surgical device 138 to help urge a tissue modifying portion of device 138 against target tissues.
  • guidewire coupling member 130 may be either attached to or formed as an integral part of surgical device distal portion 138 , according to various embodiments.
  • Coupling member 130 may be made of any suitable material, as has been mentioned previously, and may have any desired dimensions and any of a number of different configurations, some of which are described in further detail below.
  • coupling member 130 may be attached to an extreme distal end of surgical device 138 or may be positioned at or near the extreme distal end.
  • coupling member 130 is typically attached to or extending from a top or upper surface of surgical device 138 , in some embodiments it may alternatively be positioned on a bottom/lower surface or other surface.
  • a guidewire coupling member 140 including a slit 142 with one or more curves 144 and a bore 143 may be attached to a surgical device distal portion 148 .
  • a guidewire 146 having a cylindrical shaped member 147 at one end may be placed through slit 142 into bore 143 and pulled distally (solid-tipped arrow), as shown in FIG. 14A .
  • shaped member 147 is pulled into bore 143 , it is stopped by, and cannot pass through, curves 144 , thus allowing guidewire 146 to be used to pull device 148 into place between target and non-target tissues and apply tensioning force.
  • FIGS. 15A-15F an alternative embodiment of a guidewire coupling member 150 is shown with a shaped guidewire 158 .
  • Guidewire coupling member 150 may include a transverse slit 152 , an axial channel 154 and a transverse bore 156 .
  • FIG. 15E shows a front perspective view of coupling member 150 , where member 150 would be mounted on a surgical device such that a front side 151 would face distally and a back side 153 would face proximally.
  • FIG. 15F shows a rear perspective view of coupling member 150 with back side 153 and front side 151 .
  • FIG. 15A is a rear/left perspective view
  • FIG. 15B is a top view, both showing guidewire 158 with a ball-shaped member 159 being placed through transverse slit 152 into channel 154 .
  • Channel 154 is generally an open portion within coupling member 150 , having a diameter similar to or the same as that of slit 152 , to allow guidewire 158 to be rotated through coupling member 150 , as depicted by the solid-tipped, curved arrow in FIGS. 15A and 15B .
  • Bore 159 is sized to allow ball-shaped member 159 (forming the device coupling member of the guidewire) to travel into it to rest within coupling member 150 , as shown in FIGS. 15C and 15D .
  • Ball-shaped member 159 is sized such that, when shaped guidewire 158 is rotated into position within coupling member 150 , it cannot travel through channel 154 , and is thus trapped within bore 156 . Guidewire 158 may thus be pulled, to pull a device into position and/or to apply tension to the device, without guidewire 158 pulling out of coupling member 150 . Guidewire 158 may be disengaged from coupling member 150 by rotating guidewire 158 , coupling member 150 or both, to release shaped member 159 from bore 156 . In one embodiment, coupling member 150 may be attached to a top surface of a distal portion of a surgical device, such as by welding, adhesive or other attachment means.
  • guidewire coupling member 160 includes a channel 162 , a central bore 164 and a side channel, as shown in perspective view FIG. 16A , top view FIG. 16B and side view FIG. 16C .
  • Channel 162 is generally shaped and sized to allow a shaped member 169 of a guidewire 168 to pass longitudinally therethrough.
  • Central bore 164 is shaped and sized to allow shaped member 169 to rotate within bore 164 .
  • Side channel 166 is shaped and sized to allow guidewire 168 to pass therethrough when guidewire 168 is rotated about an axis through shaped member 169 .
  • An angle 165 formed by channel 162 and an opposite end of side channel 166 may be any desired angle, in various embodiments.
  • the angle in the embodiment shown is approximately 90 degrees.
  • the angle could instead be less than 90 degrees or greater than 90 degrees.
  • an angle of about 135 degrees may be used, while in another embodiment, an angle of about 180 degrees may be used.
  • shaped member 169 of guidewire 168 may be passed through channel 162 and into central bore 164 (hollow-tipped arrow). Guidewire 168 may then be rotated about an axis approximately through shaped member 169 (solid-tipped, curved arrow). When rotated, guidewire 168 passes through side channel 166 to its end, as shown in FIG. 16E . Guidewire 168 may then be pulled, to pull a device attached to coupling member 160 to a desired position in a patient's body, such as between target and non-target tissues. Rotated shaped member 169 is trapped within central bore 164 , due to its shape and size, and cannot pass into either side channel 166 or channel 162 . To remove guidewire 168 from coupling member 160 , guidewire 168 may be rotated back to the position shown in FIG. 16D and withdrawn from coupling member 160 through channel 162 .
  • FIGS. 17A-17D another alternative embodiment of a guidewire coupling member 170 is shown.
  • FIGS. 17A and 17B are front perspective and rear perspective views, respectively, in which a channel 172 and a side channel 174 of coupling member 170 may be seen.
  • FIGS. 17C and 17D are top views, showing coupling member 170 with an inserted guidewire 178 .
  • guidewire 178 with a shaped distal member 179 may be advanced through channel 172 (hollow-tipped arrow), to position shaped member 179 in a central bore 176 of coupling member 170 .
  • Guidewire 178 may then be rotated through side channel 174 about an axis approximately about shaped member 179 (solid-tipped, curved arrow). As shown in FIG. 17D , guidewire 178 may be rotated until it hits an end 175 of side channel 174 . Guidewire 178 may then be pulled to pull a device attached to coupling member 170 , as shaped member 179 will be trapped within central bore 176 , due to its shape and size. When desired, guidewire 178 may be removed from coupling member 170 by rotating guidewire 178 back to the position shown in FIG. 17C and withdrawing it through channel 172 . Channel 172 may be located at any desired angle, relative to end 175 of side channel 174 .
  • channel 172 is generally shaped and sized to allow shaped member 179 to pass longitudinally therethrough
  • central bore 176 is shaped and sized to allow shaped member 179 to rotate within bore 176
  • side channel 174 is shaped and sized to allow guidewire 178 to pass therethrough when guidewire 178 is rotated.
  • a guidewire coupling member may include a cam 300 and a stationary portion 306 (only a part of which is shown).
  • Cam may 300 rotate about an axis 302 from an open position ( FIG. 18A ), which allows a guidewire 304 to pass through, to a closed position ( FIG. 18B ), which traps guidewire 304 against stationary portion 306 .
  • cam 300 may automatically move from open to closed positions as guidewire 304 is advanced (arrow in FIG. 18A ) and may move from closed to open positions as guidewire 304 is retracted.
  • 18A and 18B may be used with a guidewire 304 that does not have a shaped member on its proximal end.
  • a coupling member may also be used with a guidewire including a coupling member, such as a shaped region.
  • FIG. 19 shows an alternative embodiment of a guidewire coupling member, which includes two opposing cams 310 that rotate toward one another (curved arrows) to grip and hold a guidewire 312 .
  • this coupling member may be used, in various embodiments, either with a guidewire having shaped proximal end or an unshaped guidewire 312 .
  • a guidewire coupling member on the surgical device may couple with the proximal end of the guidewire, even if the guidewire does not include an additional coupling member (e.g., a shaped region or other coupling member).
  • a guidewire coupling member 320 may include three movable rollers 322 .
  • rollers 322 may be arrayed to allow a guidewire 324 to pass through them.
  • Rollers 322 may be moved, relative to one another (solid-tipped arrows), to partially constrain guidewire 324 ( FIG. 20B ) or to completely constrain guidewire 324 ( FIG. 20C ).
  • Rollers 322 may be moved back to the open position ( FIG. 20A ) to release guidewire 324 .
  • a guidewire coupling member 330 may include a multi-piece cone 332 having a core 334 with a textured inner surface 335 , and a stationary portion 336 having a receptacle 338 for receiving cone 332 .
  • the two halves of cone 332 are separated and not wedged into receptacle 338 , so that a guidewire 339 may be passed through core 334 .
  • Cone 332 may be moved to a closed position, as in FIG. 21C , to grip guidewire 339 with textured surface 335 and prevent guidewire 339 from moving further through core 334 .
  • guidewire 339 may generate friction with textured surface 335 and thus pull cone 332 into receptacle.
  • guidewire 339 may either include a proximal shaped member or may not include such a member, in various embodiments.
  • a guidewire coupling member 340 may include a flat anvil 342 and one or more stationary portions 344 .
  • Anvil may be moved (hollow-tipped arrow) to pinch a guidewire 344 between itself and stationary portion 344 .
  • a guidewire coupling member 350 may include a corner-pinch mechanism 352 and one or more stationary portion 354 .
  • Mechanism 352 may be advanced (hollow-tipped arrow) to pinch guidewire 356 against stationary member 354 and thus prevent it from moving further through coupling device 350 .
  • FIG. 24 another embodiment of a guidewire coupling member 360 is shown, which includes an eccentric cam 362 that rotates (hollow-tipped arrow) to pinch a guidewire 366 between itself and a stationary portion 364 .
  • a guidewire coupling member 390 may include multiple spools 392 , through which a guidewire 394 may pass, until a shaped member 396 on one end of guidewire 394 gets caught.
  • FIG. 27B shows coupling member 390 attached with an upper surface of a surgical device distal end 391 .
  • a guidewire coupling member 400 may include a semi-circular ribbon 402 having two apertures 404 .
  • a textured guidewire 406 may be used. As textured guidewire 406 passes through apertures 404 , friction caused by the textured surface 407 causes ribbon 402 to flatten ( FIG. 28B ), thus trapping guidewire 406 in apertures 404 .
  • Ribbon 402 may be made of metal or any other suitable material, examples of which have been listed previously.
  • a guidewire coupling member 410 includes a folded ribbon 412 having multiple apertures 414 .
  • Ribbon 412 may flatten as a textured guidewire 416 passes through it, thus causing apertures to trap guidewire 416 .
  • FIG. 30 Another embodiment of a guidewire coupling member 420 is shown in FIG. 30 .
  • coupling member 420 includes a curved ribbon 422 with multiple apertures 424 .
  • Ribbon 422 may flatten to constrain a guidewire 426 in apertures 424 , as with the previously described embodiments.
  • Some embodiments of such ribbon-shaped coupling members 400 , 410 , 420 may function with a non-textured guidewire as well as, or in place of, a textured guidewire.
  • a guidewire coupling member 430 for removably coupling with a guidewire 438 may include a stationary portion 432 and a movable portion 434 .
  • Movable portion 434 may include multiple contact members 436 or locking edges, configured to hold guidewire 438 when movable portion 434 is pushed against it (hollow-tipped arrows). Movable portion 434 may be moved using any suitable technique or means in various embodiments.
  • Contact members 436 generally press guidewire 438 against stationary portion 432 such that it will not move through coupling member 430 when pulled (solid-tipped arrow), thus allowing a device coupled with coupling member 430 to be pulled using guidewire 438 .
  • a guidewire coupling member 440 may include a stationary portion 442 and a movable portion 444 , each of which has a roughened surface 446 facing one another. Movable portion 444 may be moved toward stationary portion 442 (hollow-tipped arrows) to trap guidewire 446 in between, thus preventing guidewire 446 from moving through coupling member 440 and thus allowing a device coupled with coupling member 440 to be pulled via guidewire 448 .
  • FIGS. 33A-33D several alternative embodiments of a guidewire for use with various embodiments of a guidewire coupling member and guidewire system are shown.
  • a guidewire system any of a number of currently available guidewires may be used.
  • a textured guidewire without a shaped member on either end may be used.
  • Each of the embodiments shown in FIGS. 33A-33D has some kind of shaped member on a proximal end of the guidewire for coupling with a guidewire coupling member and some kind of sharpened or otherwise shaped distal tip for facilitating passage of the guidewire through tissue.
  • guidewires may comprise a solid wire, a braided wire, a core with an outer covering or the like, and may be made of any suitable material.
  • a guidewire may be made of Nitinol.
  • guidewires may be made from any of a number of metals, polymers, ceramics, or composites thereof.
  • Suitable metals may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, ElgiloyTM (Elgin Specialty Metals, Elgin, Ill., USA), ConichromeTM (Carpenter Technology, Reading, Pa., USA), or PhynoxTM (Imphy SA, Paris, France).
  • materials for guidewires or for portions or coatings of guidewires may be chosen for their electrically conductive or thermally resistive properties.
  • Suitable polymers include but are not limited to nylon, polyester, DacronTM, polyethylene, acetal, DelrinTM (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK).
  • polymers may be glass-filled to add strength and stiffness. Ceramics may include but are not limited to aluminas, zirconias, and carbides.
  • the guidewire 180 includes a device coupling member that is configured as a ball-like shaped member 182 at the proximal end and a pointed distal tip 184 .
  • shaped member 182 may be either a separate piece attached to guidewire 180 by welding or other means or may be a proximal end of guidewire 180 , formed into shaped member 182 .
  • FIG. 33B shows a guidewire 186 with a cylindrical shaped member 188 and a beveled distal tip 190 .
  • FIG. 33C shows a guidewire 192 with a pyramidal shaped member 194 and a double-beveled distal tip 196 .
  • 33D shows a guidewire 198 with a cubic shaped member 200 and a threaded distal tip 202 .
  • the proximal end of the guidewire may include a hook for coupling with a guidewire couple.
  • any of the shaped members 182 , 188 , 194 , 200 may be combined with any of the distal tips 184 , 190 , 196 , 202 .
  • the shaped members and/or distal tips may have other shapes and/or sizes.
  • FIGS. 33A-33D are provided primarily for exemplary purposes.
  • a guidewire 204 may include a drill-shaped distal tip 206 with a cutting edge 208 .
  • a drill-shaped tip 206 may facilitate passage of guidewire 204 through tissue, as shown in FIG. 34B .
  • Guidewire 204 may be advanced through a probe 210 and through tissue (not shown) by simultaneously pushing (solid-tipped, straight arrows) and twisting (hollow-tipped, curved arrows) guidewire 204 from its proximal end.
  • Drill-shaped tip 206 may facilitate passage of guidewire 204 through tissue by acting as a drill.
  • FIGS. 37 and 38 A- 38 C illustrate another variation of an exchange system including a guidewire and a surgical device having a distal guidewire coupling exchange tip (“Rx” or exchange tip).
  • the guidewire coupling member is configured to engage the proximal end of the guidewire, which is configured as a device coupling member having a cylindrical-shaped member.
  • FIGS. 38A and 38B illustrate the coupling of the proximal end of the guidewire and the distal end of the device.
  • the two coupling regions are configured to lock when engaged, so that they may not be separated without the proper orientation and/or application of force. As illustrated in FIG.
  • the opening in the guidewire coupling member has a diameter “A” that is greater than the diameter of the short axis (“B”) of the distal end of the coupling member on the guidewire, but smaller than the longitudinal axis (“C”) of the device coupling member on the guidewire.
  • FIGS. 39A-39D illustrate a very similar variation, in which the device coupling member on the proximal end of the guidewire may be permanently secured in the guidewire coupling member.
  • the device coupling member of the guidewire has a conical, triangular or pyramidal shape in which the proximal end tapers distally so that as the proximal end of the guidewire is pulled into the guidewire coupling member of the surgical device, it become wedged and locked into the coupling member, as illustrated in FIG. 39D .
  • Other variations of locking coupling members may be used, including releasably and permanently locking members.
  • FIGS. 40A-40C illustrate another variation of a locking guidewire exchange system.
  • the proximal end of the guidewire is configured as a loop or eyelet
  • the distal end of the surgical device is configured as a hook having a progressively thicker cross-section.
  • the very proximal end of the hook may be flanged away from the body slightly, allowing the loop or eyelet to more easily engage the hook.
  • the thinner region at the proximal end may be more flexible, so that the look or eyelet can be pulled into the hook region by deflecting the thinner portion away from the longitudinal axis sufficiently to allow the loop to pass into the hook region.
  • the hook may be referred to as a “spring clip” hook.
  • the guidewire may be released from the device by applying appropriate force to pull the loop out of the spring clip hook.
  • the guidewire coupling member on the device is configured as a coil or spring into which the guidewire may be inserted.
  • the walls of the spring region may be tapered slightly to guide insertion. Pushing the guidewire into the coupling member may expand the spring slightly, whereas applying a tensioning force (e.g., by pulling on either or both the proximal end of the device and distal end of the guidewire) will tighten the connection between the guidewire and the device.
  • the guidewire also include a coupling member which may be one or more regions (e.g., rings, ridges, bumps, etc.) that can fit between the loops or coils of the guidewire coupling member on the device.
  • FIGS. 42A-42C , 43 A- 43 B, and 44 A- 44 C illustrate other variations of locking or lockable guidewire exchange systems.
  • the guidewire may be secured to a first surgical device, and tension may be applied (e.g., to pull the device into position using the guidewire, and/or to urge the device against the target tissue).
  • the devices may then be de-coupled from the guidewire (e.g., after the devices have been removed from the subject while leaving the guidewire in place), and another device may be coupled to the guidewire and positioned by pulling the guidewire and/or used to urge the device against the target tissue.
  • FIG. 42A-42C illustrate a guidewire having a loop or eyelet at the proximal end coupling with a guidewire coupling region of a surgical device that is configured as a clasp.
  • the clasp includes jaws that may move to close over the eyelet, securing it on a hook or post in the guidewire coupling region.
  • the proximal end of the guidewire is threaded and may be screwed into the guidewire coupling member of a surgical device, shown in cross section in FIG. 43B .
  • the guidewire coupling member of a surgical device includes a sliding lock may be used to secure a hinged jaw closed over the proximal end of a guidewire.
  • the lock may be slid proximally to unlock the hinged jaw and release the guidewire.
  • FIGS. 45A and 45B illustrate another variation of a spring-locking guidewire coupling region on a surgical device that mates with the device coupling region on a guidewire.
  • a spring in the guidewire coupling member pushes one or more wedge locks distally.
  • the spring and wedge locks can be displaced by pushing the proximal end of the guidewire into the coupling member proximally, but pulling distally only provides additional force to lock the guidewire in the coupling member.
  • a lock release mechanism e.g., pulling the spring or wedge locks proximally
  • a guidewire system may include a guidewire handle 220 for grasping a guidewire outside the patient.
  • a guidewire handle 220 may include, for example, a guidewire clamping mechanism 222 housed in a central, longitudinal bore 221 of handle 220 and including a central guidewire aperture 223 .
  • Handle 220 may also include a lock lever 224 for tightening clamping mechanism 222 around a guidewire.
  • distal handles handles similar to handle 220 are referred to as “distal handles,” and handles coupled with various tissue modification devices are referred to as “proximal handles.”
  • proximal handles are generally used to distinguish the two types of handles and to denote that one is more proximal than the other, during use, to a first incision or entry point into a patient, through which a guidewire system is placed and then used to pull a tissue modification device into position in the patient.
  • distal and proximal are used merely for clarification and do not refer to the relation of any device to specific anatomical structures, the position of a physician/user of the described devices/systems, or the like.
  • either type of handle may be “distal” or “proximal” relative to various structures, users or the like.
  • guidewire handle 220 denoting its function of holding a guidewire.
  • FIG. 35B provides an exploded view guidewire handle 220 .
  • a handle body 225 may be made of any suitable material and have any desired shape and size.
  • handle body 220 may be made from any of a number of metals, polymers, ceramics, or composites thereof.
  • Suitable metals may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, ElgiloyTM (Elgin Specialty Metals, Elgin, Ill., USA), ConichromeTM (Carpenter Technology, Reading, Pa., USA), or Phyno (Imphy SA, Paris, France).
  • Suitable polymers include but are not limited to nylon, polyester, DacronTM, polyethylene, acetal, DelrinTM (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Ceramics may include but are not limited to aluminas, zirconias, and carbides.
  • Clamping mechanism 222 may include, for example, a snap ring 226 , a keeper washer 228 , a flat anvil 230 , and a cage barrel 232 , all of which fit within central bore 221 of handle body 225 .
  • Lock lever 224 may be coupled with a pinch screw 234 and a shoulder screw 236 . When lock lever 224 is turned in one direction, it pushes shoulder screw 236 against clamping mechanism 222 to cause mechanism 222 to clamp down on a guidewire. Lock lever 224 may be turned in an opposite direction to loosen clamping mechanism 222 , thus allowing a guidewire to be introduced into or release from central guidewire aperture 223 .
  • FIGS. 36A-36B illustrate one method of using an exchange system as described.
  • FIG. 36A shows a spinal region including a neural foramen into which a cannulated probe (curve cannula) has been inserted.
  • the guidewire is inserted into the tissue (e.g., through a neural foramen) so that the pathway through the tissue includes at least one (or only one) bend or curve in which the target tissue is positioned within the radius of the curve.
  • the guidewire may be positioned by one or more access devices.
  • FIG. 36A shows positioning of a guidewire using an access cannula having an integrated curved inner cannula slidably disposed within the outer cannula.
  • the inner curved member is extended from the distal end of the access cannula into the foramen and around the target tissue, as shown.
  • a guidewire may then be inserted through it, so that a distal end of the guidewire (which may be sharp) extends from the patient.
  • Either or both the cannula and the curved inner member may also include a neural localization electrode or electrodes so that the guidewire can be positioned away from the nerve.
  • the access cannula can then be retracted and removed from the patient, leaving the guidewire behind. As illustrated in FIGS.
  • the guidewire may then be used (as described in detail above) to pull a surgical device (e.g., a cutting device, etc.) through the body so that it is positioned relative to the target tissue.
  • a surgical device e.g., a cutting device, etc.
  • the proximal end of the cannula initially protruding from the patient, may be coupled to a surgical device, as described above.
  • the distal end of the guidewire can then be pulled to draw the surgical device through the patient until it is positioned as desired relative to the target tissue.
  • Positioning may be confirmed by one or more of a direct visualization technique, feel (e.g., tactile feedback on the guidewire and/or surgical device), sensors on the surgical device or guidewire, depth markers on the guidewire or surgical device, or the like.
  • tension may be applied to the surgical device.
  • the guidewire remains at least partially in the patient and attached to the surgical device.
  • Tension may be applied by pulling distally on the guidewire and proximally on the surgical device, to urge the surgical device against the target tissue.
  • the surgical device may then be moved (e.g., back and forth across the target tissue) to mechanically actuate the surgical device, or it may be otherwise actuated, as described previously.
  • the device may be withdrawn from the patient. For example, the device may be withdrawn by pulling it proximally out of the patient, until the proximal end of the guidewire is again outside of the patient.
  • the surgical device can then be exchanged on the guidewire.
  • the proximal end of the guidewire may then be de-coupled from the surgical device, and another surgical device may be coupled, as previously described.
  • the surgical device can again be positioned adjacent to the target tissue, and the device can be urged against the target tissue. This procedure may be repeated as often as necessary until the target tissue has been treated to the desired level.
  • any appropriate surgical device may be used an applied in this way, including (but not limited to) decompression devices, measuring devices (balloons, sounds, etc.), catheters or other devices for suction and irrigation, and devices for delivering active agents (i.e., hemostatic agents such as Thrombin, steroids, or other drugs), bone wax, etc.
  • Implants may also be positioned by pulling then through the subject using the guidewire.
  • the guidewire may be removed from the subject.

Abstract

Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
This application is claims the benefit as a continuation-in-part of pending U.S. patent application Ser. No. 11/251,199, filed on Oct. 15, 2005, titled “Devices and Methods for Tissue Modification”; which claims the benefit of U.S. Provisional Patent Application Ser. No. 60/685,190, filed on May 27, 2005, titled “Methods and Apparatus for Selective Surgical Removal of Tissue”; U.S. Provisional Patent Application Ser. No. 60/681,719, filed May 16, 2005, titled “Methods and Apparatus for Selective Surgical Removal of Tissue”; U.S. Provisional Patent Application Ser. No. 60/681,864, filed May 16, 2005, titled “Methods and Apparatus for Selective Surgical Removal of Tissue”; U.S. Provisional Patent Application Ser. No. 60/622,865, filed Oct. 28, 2004, titled “Methods and Apparatus for Selective Surgical Removal of Tissue”; and U.S. Provisional Patent Application Ser. No. 60/619,306, filed Oct. 15, 2004, titled “Methods and Apparatus for the Treatment of Tissue Impingement in the Spine”.
This application also claims the benefit as a continuation-in-part of pending U.S. patent application Ser. No. 11/468,247, filed on Aug. 29, 2006, titled “Tissue Access Guidewire System and Method.” Each of these patent applications is herein incorporated by reference in their entirety.
BACKGROUND OF THE INVENTION
The devices, methods and systems described herein relate generally to medical/surgical devices and methods. More specifically, they may relate to guidewire systems and methods for advancing one or more surgical devices between tissues in a patient.
In recent years, less invasive (or “minimally invasive”) surgical techniques have become increasingly more popular, as physicians, patients and medical device innovators have sought to achieve similar or improved outcomes, relative to conventional surgery, while reducing the trauma, recovery time and side effects typically associated with conventional surgery. Developing less invasive surgical methods and devices, however, can pose many challenges. For example, some challenges of less invasive techniques include working in a smaller operating field, working with smaller devices, and trying to operate with reduced or even no direct visualization of the structure (or structures) being treated. These challenges are compounded by the fact that target tissues to be modified often reside very close to one or more vital, non-target tissues, which the surgeon hopes not to damage. One of the initial obstacles in any given minimally invasive procedure, therefore, is positioning a minimally invasive surgical device in a desired location within the patient to perform the procedure on one or more target tissues, while avoiding damage to nearby non-target tissues.
Examples of less invasive surgical procedures include laparoscopic procedures, arthroscopic procedures, and minimally invasive approaches to spinal surgery, such as a number of less invasive intervertebral disc removal, repair and replacement techniques.
One area of spinal surgery in which a number of less invasive techniques have been developed is the treatment of spinal stenosis. Spinal stenosis occurs when neural and/or neurovascular tissue in the spine becomes impinged by one or more structures pressing against them, causing one or more symptoms. This impingement of tissue may occur in one or more of several different areas in the spine, such as in the central spinal canal, or more commonly in the lateral recesses of the spinal canal and/or one or more intervertebral foramina.
FIGS. 1-3 show various partial views of the lower (lumbar) region of the spine. FIG. 1 shows an approximate top view of a vertebra with the cauda equina (the bundle of nerves that extends from the base of the spinal cord through the central spinal canal) shown in cross section and two nerve roots exiting the central spinal canal and extending through intervertebral foramina on either side of the vertebra. The spinal cord and cauda equina run vertically along the spine through the central spinal canal, while nerve roots branch off of the spinal cord and cauda equina between adjacent vertebrae and extend through the intervertebral foramina. Intervertebral foramina may also be seen in FIGS. 2 and 3, and nerves extending through the foramina may be seen in FIG. 2.
One common cause of spinal stenosis is buckling and thickening of the ligamentum flavum (one of the ligaments attached to and connecting the vertebrae), as shown in FIG. 1. (Normal ligamentum flavum is shown in cross section in FIG. 3) Buckling or thickening of the ligamentum flavum may impinge on one or more neurovascular structures, dorsal root ganglia, nerve roots and/or the spinal cord itself. Another common cause of neural and neurovascular impingement in the spine is hypertrophy of one or more facet joints (or “zygopophaseal joints”), which provide articulation between adjacent vertebrae. (Two vertebral facet superior articular processes are shown in FIG. 1. Each superior articular process articulates with an inferior articular process of an adjacent vertebra to form a zygopophaseal joint. Such a joint is labeled in FIG. 3.) Other causes of spinal stenosis include formation of osteophytes (or “bone spurs”) on vertebrae, spondylolisthesis (sliding of one vertebra relative to an adjacent vertebra), facet joint synovial cysts, and collapse, bulging or herniation of an intervertebral disc into the central spinal canal. Disc, bone, ligament or other tissue may impinge on the spinal cord, the cauda equina, branching spinal nerve roots and/or blood vessels in the spine to cause loss of function, ischemia and even permanent damage of neural or neurovascular tissue. In a patient, this may manifest as pain, impaired sensation and/or loss of strength or mobility.
In the United States, spinal stenosis occurs with an incidence of between 4% and 6% of adults aged 50 and older and is the most frequent reason cited for back surgery in patients aged 60 and older. Conservative approaches to the treatment of symptoms of spinal stenosis include systemic medications and physical therapy. Epidural steroid injections may also be utilized, but they do not provide long lasting benefits. When these approaches are inadequate, current treatment for spinal stenosis is generally limited to invasive surgical procedures to remove ligament, cartilage, bone spurs, synovial cysts, cartilage, and bone to provide increased room for neural and neurovascular tissue. The standard surgical procedure for spinal stenosis treatment includes laminectomy (complete removal of the lamina (see FIGS. 1 and 2) of one or more vertebrae) or laminotomy (partial removal of the lamina), followed by removal (or “resection”) of the ligamentum flavum. In addition, the surgery often includes partial or occasionally complete facetectomy (removal of all or part of one or more facet joints). In cases where a bulging intervertebral disc contributes to neural impingement, disc material may be removed surgically in a discectomy procedure.
Removal of vertebral bone, as occurs in laminectomy and facetectomy, often leaves the affected area of the spine very unstable, leading to a need for an additional highly invasive fusion procedure that puts extra demands on the patient's vertebrae and limits the patient's ability to move. In a spinal fusion procedure, the vertebrae are attached together with some kind of support mechanism to prevent them from moving relative to one another and to allow adjacent vertebral bones to fuse together. Unfortunately, a surgical spine fusion results in a loss of ability to move the fused section of the back, diminishing the patient's range of motion and causing stress on the discs and facet joints of adjacent vertebral segments. Such stress on adjacent vertebrae often leads to further dysfunction of the spine, back pain, lower leg weakness or pain, and/or other symptoms. Furthermore, using current surgical techniques, gaining sufficient access to the spine to perform a laminectomy, facetectomy and spinal fusion requires dissecting through a wide incision on the back and typically causes extensive muscle damage, leading to significant post-operative pain and lengthy rehabilitation. Discectomy procedures require entering through an incision in the patient's abdomen and navigating through the abdominal anatomy to arrive at the spine. Thus, while laminectomy, facetectomy, discectomy, and spinal fusion frequently improve symptoms of neural and neurovascular impingement in the short term, these procedures are highly invasive, diminish spinal function, drastically disrupt normal anatomy, and increase long-term morbidity above levels seen in untreated patients. Although a number of less invasive techniques and devices for spinal stenosis surgery have been developed, these techniques still typically require removal of significant amounts of vertebral bone and, thus, typically require spinal fusion.
Therefore, it would be desirable to have less invasive surgical methods and systems for treating spinal stenosis. For example, it would be desirable to have devices or systems for positioning a less invasive device in a patient for performing a less invasive procedure. Ideally, such systems and devices would be less invasive than currently available techniques and thus prevent damage to non-target vertebral bone and neural and neurovascular structures. Also ideally, such systems and devices would also be usable (or adaptable for use) in positioning a surgical device in parts of the body other than the spine, such as in joints for performing various arthroscopic surgical procedures, between a cancerous tumor and adjacent tissues for performing a tumor resection, and the like.
In particular, it would be useful to provided devices, systems and methods for gaining access using a guidewire that could be easily exchanged to position and apply tension to a plurality of devices, including surgical devices such as tissue localization devices, tissue modification devices, or the like. Described herein are devices, methods and system which may address these needs.
SUMMARY OF THE INVENTION
Described herein are devices, systems and method for positioning, actuating and exchanging various tissue access, treatment, and localization devices. In particular, described herein are exchange systems using a guidewire which may be used to both position and/or actuate a variety of such devices, while allowing exchange of such devices. Systems including these guidewires may be referred to herein as “exchange systems”, “guidewire systems,” “guidewire exchange systems” or the like.
For example, described herein are methods of exchanging a surgical device while treating a patient. These methods may include the steps of advancing a guidewire at least partially around a target tissue in a patient so that the proximal end of the guidewire extends from a first site on the patient and the distal end of the guidewire extends from a second site on the patient, coupling the proximal end of the guidewire on or near the distal end of a first surgical device, positioning the first surgical device by pulling the distal end of the guidewire, de-coupling the proximal end of the guidewire from the first surgical device, coupling the proximal end of the guidewire to a second surgical device, and positioning the second surgical device by pulling the distal end of the guidewire.
In some variations, the method may also include the step of withdrawing the first surgical device from the patient by pulling on the proximal end of the first surgical device. For example, the surgical device may be a relatively elongate device having a flexible distal end. The distal region of the device is preferably low-profile, and may be flat or thin. Surgical devices appropriate for use with the methods and systems described herein may be pulled into the subject using the guidewire, so that the proximal end of the surgical device (or a connector connected to the proximal end) remains outside of the patient. Thus, the first surgical device comprises an elongate surgical device having a flexible distal end. For example, the surgical device may be a tissue modification device (e.g., having a surface including one or more tissue modification elements).
The method may also include the step of urging the first surgical device against the target tissue by applying tension to either or both of the first surgical device extending from the first site and the guidewire extending from the second site. Similarly, the method may also include the step of urging the second surgical device against the target tissue by applying tension to either or both of the second surgical device extending from the first site and the guidewire extending from the second site.
The step of advancing the guidewire may include advancing the guidewire through a spinal foramen, particularly an intervertebral foramen.
Neural tissue localization may also be included as a part of the methods described herein. It may be particularly beneficial to confirm that neural tissue (e.g., a nerve) is not located between the target tissue and the guidewire before performing a procedure on the target tissue. Any appropriate tissue localization step may be used. For example, the tissue adjacent to the pathway of the guidewire may be directly visualized (using an endoscope, etc.), or indirectly visualized (using a medical imaging technology). Electrical tissue stimulation may be used. Examples of tissue localization methods, devices and systems that may be used can be found in U.S. patent application Ser. No. 12/060,229 (titled “SYSTEM AND APPARATUS FOR NEURAL LOCALIZATION”), filed Mar. 31, 2008, herein incorporated by reference in its entirety. In some variations, an electrical current is applied to the tissue adjacent the pathway of the guidewire to stimulate a nerve. Stimulation can be detected (e.g., by muscle twitch, EMG, etc.). Thus, the step of advancing the guidewire may include the step of confirming that a non-target nerve is not between the target tissue and the path of the guidewire, and in some variations the step of confirming that a non-target nerve is not between the target tissue and the path of the guidewire comprises applying electrical energy to the tissue.
Also described herein are methods of exchanging a surgical device while treating a patient that include the steps of: advancing a guidewire through an intervertebral foramen and at least partially around a target tissue in a patient so that the proximal end of the guidewire extends from a first site on the patient and the distal end of the guidewire extends from a second site on the patient, coupling the proximal end of the guidewire on or near the distal end of a first surgical device, pulling the distal end of the guidewire to position the first surgical device adjacent the target tissue, removing the first surgical device from the patient while leaving the guidewire in the patient, de-coupling the proximal end of the guidewire from the first surgical device, coupling the proximal end of the guidewire to a second surgical device, and pulling the distal end of the guidewire to position the second surgical device.
Also described herein are methods of treating a patient, the method including the step of advancing a distal end of a guidewire into the patient's body from a first site, advancing the distal end at least partially around a target tissue, extending the distal end of the guidewire out of the body from a second site, while maintaining a proximal end of the guidewire outside the body at the first site, coupling the proximal end of the guidewire on or near a distal end of a surgical device, and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position adjacent to the target tissue.
In many of the methods described herein, the guidewire is inserted through the patient's body so that both the proximal and distal ends of the guidewire extend from the body, typically (but not necessarily) from separate entry and exit sites. The path that the guidewire takes is curved or bent, and the bend occurs adjacent to the target tissue. This may allow the guidewire or a device attached to the guidewire to be urged specifically against the target tissue by applying tension. For example, one or both ends of the guidewire (or a device attached to the guidewire) may be pulled, urging the device against the target tissue. Thus, the method may include the step of urging the surgical device against the target tissue by applying tension to either or both of the surgical device extending from the first site and the guidewire extending from the second site.
The step of coupling the proximal end of the guidewire on or near the distal end of the surgical device may include coupling the proximal end of the guidewire to the surgical device with at least one coupling member. For example, the step may include engaging a guidewire coupling member on the surgical device with the distal end of the guidewire.
In some variations, the method also includes the step of locking the proximal end of the guidewire on or near a distal end of a surgical device. The guidewire may be permanently or releasably locked to the surgical device. For example, the guidewire may be permanently locked by crimping the coupling member or be lodging the guidewire (e.g., the shaped proximal end of the guidewire) within the coupling member of the surgical device.
The method may also include the step of performing a surgical procedure on the target tissue using the surgical device. For example, the step of performing a surgical procedure may include reciprocating the surgical device by pulling on either or both of the surgical device extending from the first site and the guidewire extending from the second site.
The method may also include the step of withdrawing the surgical device proximally from the patient. In some variations, the method also includes de-coupling the proximal end of the guidewire from the surgical device and coupling the proximal end of the guidewire on or near a distal end of a second surgical device.
Also described herein are methods for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body. These methods may include the steps of: advancing a distal end of a guidewire into the patient's body, between two tissues, and out of the body, while maintaining a proximal end of the guidewire outside the body, coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a surgical device, and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues.
Also described herein are methods for performing a procedure on a target tissue in a patient's body. These methods may include coupling a proximal end of a guidewire with at least one coupling member on or near a distal end of a surgical device, pulling a distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues, such that an active portion of the surgical device faces target tissue and an atraumatic portion of the surgical device faces non-target tissue, and performing a procedure on the target tissue, using the surgical device.
INCORPORATION BY REFERENCE
All publications and patent applications mentioned herein are hereby incorporated by reference in their entirety as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is cross-sectional view of a spine, showing a top view of a lumbar vertebra, a cross-sectional view of the cauda equina, and two exiting nerve roots.
FIG. 2 is a left lateral view of the lumbar portion of a spine with sacrum and coccyx.
FIG. 3 is a left lateral view of a portion of the lumbar spine, showing only bone and ligament tissue and partially in cross section.
FIG. 4 is a cross-sectional view of a patient's back and spine with a side view of a guidewire and tissue modification system in place for performing a tissue removal procedure.
FIG. 6 is a cross-sectional view of a patient's back and spine and a side view of a rasp device and guidewire system.
FIGS. 5A-5I illustrate one variation of a method for advancing a tissue modifying device into a patient's body using a guidewire delivery system.
FIG. 7 is a cross-sectional view of a patient's back and spine and a side view of an ultrasound device and guidewire system.
FIG. 8A is a cross-sectional view of a patient's back and spine and a side view of a tissue access device with swappable tissue modification devices and a guidewire system.
FIGS. 8B-8M are side/perspective views of distal portions of a number of different devices which may be placed through/used with a tissue access device such as that shown in FIG. 8A.
FIG. 9 is a cross-sectional view of a patient's back and spine and a side view of a tissue access device with swappable tissue modification devices and a guidewire system.
FIG. 10 is a perspective view of a tissue access device coupled with a guidewire.
FIG. 11 is a perspective view of a tissue access device coupled with a guidewire.
FIG. 12 is a perspective view of a tissue access device coupled with a guidewire.
FIGS. 13A and 13C are perspective views, and FIGS. 13B and 13D are top views, of a distal end of a tissue modification device with guidewire coupling member and a shaped guidewire.
FIGS. 14A and 14B are perspective views of a distal end of a tissue modification device with guidewire coupling member and a shaped guidewire.
FIGS. 15A and 15C are perspective views of a guidewire coupling member and a shaped guidewire, demonstrating a method for coupling the two.
FIGS. 15B and 15D are top views of the guidewire coupling member and shape guidewire of FIGS. 15A and 15C.
FIGS. 15E and 15F are different perspective views of the guidewire coupling member of FIGS. 15A and 15C, without the shaped guidewire.
FIGS. 16A-16C are perspective, top and side views, respectively, of a guidewire coupling member.
FIGS. 16D and 16E are top views of the guidewire coupling member of FIGS. 16A-16C and a shaped guidewire, demonstrating a method for coupling the coupling member with a shaped guidewire.
FIGS. 17A and 17B are perspective views of a guidewire coupling member.
FIGS. 17C and 17D are top views of the guidewire coupling member of FIGS. 17A and 17B and a shaped guidewire, demonstrating a method for coupling the coupling member with the guidewire.
FIGS. 18A and 18B are top views of a single-cam guidewire coupling member.
FIG. 19 is a top view of a double-cam guidewire coupling member.
FIGS. 20A-20C are top views of a movable-piece guidewire coupling member.
FIG. 21A is a perspective view, and FIGS. 21B and 21C are side cross-sectional views, of a split-cone guidewire coupling member.
FIG. 22 is a top view of a flat anvil guidewire coupling member.
FIG. 23 is a top view of a corner pinch guidewire coupling member.
FIG. 24 is a top view of an eccentric cam guidewire coupling member.
FIGS. 25A and 25B are perspective views of a hooked guidewire and receiving guidewire coupling member.
FIGS. 26A and 26B are perspective views of a ball-and-socket guidewire and guidewire coupling member.
FIGS. 27A and 27B are top and perspective views, respectively, of a spool trap guidewire coupling member.
FIGS. 28A and 28B are side views of a semicircular ribbon guidewire coupling member with textured guidewire.
FIG. 29 is a side view of a folded ribbon guidewire coupling member with textured guidewire.
FIG. 30 is a side view of a ribbon guidewire coupling member.
FIG. 31 is a side view of a multi-point guidewire coupling member.
FIG. 32 is a side view of a rough-surface guidewire coupling member.
FIGS. 33A-33D are side views of proximal and distal ends of various guidewires.
FIG. 34A is a perspective view of a drill-shaped distal end of a guidewire.
FIG. 34B is a side view of a guidewire as in FIG. 34A, being passed through a probe device.
FIGS. 35A and 35B are perspective and exploded views of a handle for grasping a guidewire.
FIGS. 36A to 36C illustrate one method of exchanging a device using a positioned guidewire.
FIG. 37 shows a perspective view of one variation of an exchange system.
FIGS. 38A and 38B illustrate locking of the exchange system of FIG. 37.
FIG. 38C is a cross-section through the system shown in FIG. 37, showing exemplary dimensions.
FIG. 39A is a perspective view of another variation of an exchange system.
FIGS. 39B and 39C illustrate locking of the exchange system of FIG. 39A.
FIG. 39D is a cross-section through the system shown in FIG. 39A, showing exemplary dimensions.
FIG. 40A is a perspective view of another variation of an exchange system.
FIG. 40B illustrates locking of the exchange system of FIG. 40A.
FIG. 40C shows a perspective view of one of the coupling members shown in FIG. 40A.
FIG. 41A is perspective view of a locking exchange system.
FIGS. 41B and 41C are cross-sectional views illustrating the operation of the exchange system shown in FIG. 41A.
FIGS. 42A-42C illustrate another locking exchange system.
FIGS. 43A-43B illustrate an exchange system including a threaded coupling region.
FIGS. 44A-44C illustrate operation of a locking exchange system.
FIG. 45A is a perspective view of an exchange system; FIG. 45B is a cross-section of the exchange system shown in FIG. 45A.
FIG. 45C shows one variation of a locking portion in a coupling member of the exchange system shown in FIG. 45A.
DETAILED DESCRIPTION OF THE INVENTION
In general, the guidewire systems described herein includes a guidewire and at least one surgical device that are configured so that the proximal end of the guidewire couples to the distal end of the guidewire. The guidewire typically has a distal end that is configured to extend from a subject's body and be manipulated, and a proximal end that includes a coupling member for coupling to the surgical device. The coupling member may be referred to as a device coupling member and may be located at or near the proximal end of the guidewire. Any appropriate surgical device or devices may be included as part of the guidewire system. The surgical device typically includes a coupling member on or near its distal end that is configured to mate with the coupling member on or near the proximal end of the guidewire. The device-side coupling member may be referred to as a guidewire coupling member.
Methods of using these systems, and particularly methods of quickly exchanging surgical devices during a procedure, are described in greater detail below.
Various embodiments of a guidewire system and method for positioning one or more surgical devices in a patient are provided. Although the following description and accompanying drawing figures generally focus on positioning various surgical devices in a spine, in alternative embodiments, guidewire systems and methods of the present invention may be used to position any of a number of devices in other anatomical locations in a patient's body.
Referring to FIG. 4, one embodiment of a guidewire system 10 is shown coupled with a tissue cutting device 11 in position within a patient's spine. Further description of various embodiments of cutting device 11 may be found in U.S. patent application Ser. No. 11/461,740, entitled “Multi-Wire Tissue Cutter”, and filed Aug. 1, 2006, the full disclosure of which is hereby incorporated by reference. A number of alternative embodiments of cutting devices, many of which may be used (or adapted for use) with guidewire system 10, are further described in U.S. patent application Ser. No. 11/375,265, entitled “Methods and Apparatus for Tissue Modification”, and filed Mar. 13, 2006; Ser. No. 11/405,848, entitled “Mechanical Tissue Modification Devices and Methods”, and filed Apr. 17, 2006; Ser. No. 11/406,486, entitled “Powered Tissue Modification Devices and Methods”, and filed Apr. 17, 2006; and Ser. No. 11/429,377, entitled “Flexible Tissue Rasp”, and filed May 4, 2006. The full disclosures of all of the foregoing references are hereby incorporated by reference.
As described in further detail in U.S. patent application Ser. No. 11/461,740, tissue cutting device 11 may include a shaft 12, a proximal handle 16, a flexible distal portion 13, two or more cutting blades 26 and a guidewire coupling member 30. Guidewire system 10 may include a guidewire 32 having a sharpened tip 33 (often referred to herein as the “sharpened distal tip”) for facilitating advancement of guidewire 32 through tissue. Optionally, guidewire 32 may also include a device coupling member that is configured as a shaped member (not visible in FIG. 4) at the end opposite sharpened tip 33 (often referred to herein as the guidewire “proximal end”) for coupling with coupling member 30. Guidewire system 10 may also include a guidewire handle 34 (or “distal handle”) for coupling with guidewire 32, which in some cases may include a tightening member 36 for securing a portion of guidewire 32 within guidewire handle 34.
In some embodiments, cutting device 11 may be advanced into a patient's back through an incision 20, which is shown in FIG. 4 as an open incision but which may be a minimally invasive or less invasive incision in alternative embodiments. In some embodiments, device 11 may be advanced by coupling guidewire connector 30 with guidewire 32 that has been advanced between target and non-target tissues, and then pulling guidewire 32 to pull device 11 between the tissues. Various embodiments of such a method for delivering a device are described in further detail below. Generally, guidewire system 10 may be used to pull flexible distal portion 13 into place between tissues in hard-to-reach or tortuous areas of the body, such as between a nerve root (NR) and facet joint and through an intervertebral foramen (IF). Generally, flexible portion 13 may be advanced to a position such that blades 26 face tissue to be cut in a tissue removal procedure (“target tissue”) and a non-cutting surface (or surfaces) of flexible portion 13 faces non-target tissue, such as nerve and/or neurovascular tissue. In the embodiment shown in FIG. 4, blades 26 are positioned to cut ligamentum flavum (LF) and may also cut hypertrophied bone of the facet joint, such as the superior articular process (SAP). (Other anatomical structures depicted in FIG. 4 include the vertebra (V) and cauda equina (CE)). In various alternative embodiments, flexible portion 13 may be replaced with a curved, rigid portion, a steerable portion, a straight portion with a distal extension or the like. The configuration, dimensions, flexibility, steerability, materials and the like of flexible portion 13 may be adjusted, in alternative embodiments, depending on a type of tissue or anatomical structure to be accessed or modified.
Before or after blades 26 are located in a desired position, guidewire 32 may be removably coupled with guidewire handle 34, such as by passing guidewire 32 through a central bore in handle 34 and moving tightening member 36 to secure a portion of guidewire 32 within handle 34. A physician (or two physicians or one physician and an assistant) may then pull on proximal handle 16 and distal handle 34 to apply tensioning force to guidewire 32 and cutting device 11 and to urge the cutting portion of device 11 against ligamentum flavum (LF), superior articular process (SAP), or other tissue to be cut. Proximal handle 16 may then be actuated, such as by squeezing in the embodiment shown, to cause one or both blades 26 to move toward one another to cut tissue. Proximal handle 16 may be released and squeezed as many times as desired to remove a desired amount of tissue. When a desired amount of tissue has been cut, guidewire 32 may be released from distal handle 34, and cutter device 11 and guidewire 32 may be removed from the patient's back.
With reference now to FIGS. 5A-51, one embodiment of a method for advancing a tissue modifying device into a patient's body using a guidewire delivery system is shown. Although this method is shown in reference to placement of a device in a spine, in various alternative embodiments, such a method may be used to place similar or alternative tissue modification devices in other locations in a human body, such as between tissues in a joint space, in the abdominal cavity, or in the carpal tunnel of the wrist, between bone and soft tissue in other parts of the body, and the like.
Referring to FIG. 5A, in one embodiment of a method for advancing a tissue modifying device, a probe 40 may be inserted into a patient's back using an open technique facilitated by retractors 42. Target tissues of a procedure, in this embodiment, may include ligamentum flavum (LF) and/or facet joint (F) tissue of a vertebra (V), which may impinge on non-target tissues, such as nerve root (NR) and/or cauda equina (CE), of the lumbar spine. Also depicted in FIG. 5A is an intervertebral disc (D). In FIG. 5B, a curved distal portion of probe 40 has been advanced to a position between target ligamentum flavum (LF) and non-target nerve root (NR) tissues. As depicted in FIG. 5C, in some embodiments, a curved guide member 46 may next be advanced out of an aperture on the curved distal portion of probe 40. In one embodiment, for example, guide member 46 may be housed within probe and advanced out of the distal aperture by advancing a slide member 44 on the shaft of probe 40. Next, as shown in FIG. 5D, guidewire 32 may be advanced through guide member 46 and out of the patient's back, using sharpened tip 33 to facilitate passage through the patient's back tissue. Probe 40 may then be removed, as shown in FIG. 5E, leaving guidewire 32 in place between the target and non-target tissues, as shown in FIG. 5F. Also shown in FIG. 5F is a shaped member 50 (in this embodiment, a ball) on the proximal end of guidewire 32.
Further description of methods, devices and systems for advancing a guidewire between tissues using a probe are provided in U.S. patent application Ser. No. 11/429,377, entitled “Spinal Access and Neural Localization” and filed on Jul. 13, 2006, the full disclosure of which is hereby incorporated by reference. As described in that reference, in some embodiments, the curved distal portion of probe 40, curved guide member 46, or both may include one, two or more electrodes to help locate nerve tissue before placing guidewire 32. Such neural localization helps ensure that guidewire 32 is positioned between target and non-target tissue, which in turn helps ensure that a tissue modification device (or devices) placed using guidewire 32 are oriented so that a tissue modifying portion (or portions) of the device face and act on target tissue and not on non-target tissue such as neural tissue.
Referring now to FIG. 5G, once guidewire 32 is positioned between tissues, its proximal end with shaped member 50 may be coupled with a coupling member (i.e., guidewire coupling member 62) on a distal end of a tissue modification device 52. Tissue modification device 52, in one embodiment, may include a proximal handle 54, a rigid proximal shaft portion 56, a flexible distal shaft portion 58, tissue cutting blades 60, and coupling member 62. Coupling member 62, various embodiments of which are described in greater detail below, may be either attached to or formed in distal shaft portion 58. In some embodiments, such as the one depicted in FIG. 5G, to attach guidewire 32 to coupling member 62, guidewire 32 may be laid into a channel on coupling member 62, and guidewire 32 and/or distal portion 58 may be rotated, relative to one another, to lock shaped member 50 into coupling member. Various alternative embodiments for coupling guidewires 32 with coupling members 62 are described in greater detail below. Before, after or during coupling of guidewire 32 and tissue modification device 52, guidewire 32 may also be coupled with distal guidewire handle 34, such as by advancing distal handle 34 over guidewire 32 (solid-tipped arrow).
As depicted in FIG. 5H, tightening member 36 may next be moved (curved, solid-tipped arrow) to tighten distal handle 34 around guidewire 32. Distal handle 34 may then be pulled (straight, solid-tipped arrow) to pull guidewire 32 and thus advance distal shaft portion 58 of tissue modification device 52 into place between target and non-target tissues in the spine, as shown in FIG. 5I. Once device 52 is positioned as desired, as depicted in FIG. 5I, proximal handle 54 and distal handle 34 may be pulled (straight, solid-tipped arrows), to apply tensioning force to guidewire 32 and device 52 and thus urge flexible portion 58 and blades 60 against target tissue, such as ligamentum flavum (LF) and/or facet joint (F) tissue. Handle 54 may then be actuated (curved, double-tipped arrow) to cause blades 60 to cut target tissue. When a desired amount of tissue is cut, guidewire 32 may be released from distal handle 34, and tissue modification device 52 and guidewire 32 may be removed from the patient's back. Alternatively, the guidewire may be left at least partially in the body so that it can be used to position and/or actuate other surgical device. This method for advancing tissue modification device 52 using guidewire 32 is but one exemplary embodiment.
Various aspects of the method embodiment just described, such as the number or order of steps, may be changed without departing from the scope of the invention. Furthermore, a number of alternative embodiments of various devices and device elements are described below, which may be used in various embodiments of such a method. For example, in one alternative embodiment (not shown), probe 40 and tissue modification device 52 may be combined into one device. Such a device may include a guidewire lumen through which guidewire 32 may be passed. The combined device may be partially inserted into a patient, and guidewire 32 advanced between target and non-target tissues through the guidewire lumen. Shaped member 50 (device coupling member) of guidewire 32 may then catch on one or more coupling members 62 of the combined device (guidewire coupling member), to allow the device to be pulled into position between the target and non-target tissues. Guidewire 32 may then further be used to help apply tensioning force to the device to urge an active portion against target tissues. In another alternative embodiment, access to the intervertebral foramen may be achieved using a lateral approach, rather than a medial approach. These are but two examples of many alternative embodiments, and a number of other alternatives are contemplated.
With reference now to FIG. 6, guidewire system 10 is shown with an alternative embodiment including a tissue modification device 64, which may include a proximal handle 66, a rigid proximal shaft portion 68, and a distal flexible shaft portion 70. Multiple abrasive members 72 and a guidewire coupling member 74 may be coupled with one side of flexible shaft portion 70. In this embodiment, guidewire 32 may be coupled with coupling member 74 and used to pull distal shaft portion 70 of modification device 64 into place between target and non-target tissues. Proximal handle 66 and distal handle 34 may then be pulled/tensioned (solid-tipped arrows) to urge abrasive members 72 against the target tissue, and handles 66, 34 may further be used to reciprocate device 64 and guidewire 32 back and forth (hollow/double-tipped arrows) to modify the target tissue. Reciprocation and tensioning may be continued until a desired amount of tissue is removed, at which point guidewire 32 may be released from distal handle 34, and device 64 and guidewire 32 may be removed from the patient's back. In various embodiments, tissue modification device 64 may include any of a number of abrasive members 72, abrasive materials, or the like, which may be arrayed along distal shaft portion 70 for any desired length and in any desired configuration. Further examples of abrasive members 70, materials, surfaces and the like are described in U.S. patent application Ser. No. 11/429,377, which was previously incorporated by reference. In various alternative embodiments, shaft portions 68, 70 may both be rigid or may both be flexible and may have different cross-sectional shapes or the same shape.
Referring to FIG. 7, in another alternative embodiment, an ultrasound tissue modification device 76 may be advanced into position in a patient's back using guidewire system 10. In one embodiment, for example, ultrasound device 76 may include a proximal handle 78, a hollow shaft 80 having a distal window 81, multiple ultrasound wires 82 extending through shaft 80 and into window 81, a guidewire connector 84 coupled with a tapered distal end of shaft 80, an ultrasound generator 88, and a wire 86 coupling handle 78 with generator 88. Handle 78 may include, for example, an ultrasound transducer, horn and/or other ultrasound transmission components. Shaft 80 may be completely rigid, completely flexible, or part rigid/part flexible, according to various embodiments. Ultrasound energy provided by generator 88 may be converted in handle 78 to reciprocating motion of wires 82, and reciprocating wires 82 may be used to cut, chisel or otherwise modify soft and/or hard tissues. Further description of such an embodiment is provided in U.S. patent application Ser. No. 11/461,740, which was previously incorporated by reference. Guidewire connector 84 may comprise one of a number of different connectors, various embodiments of which are described in further detail below.
In another embodiment, and with reference now to FIG. 8A, guidewire system 10 may be used to pull/advance a tissue access device 90 into place between target and non-target tissues. Tissue access device 90, for example, may include a proximal handle 92, a hollow shaft 94 having a distal curved portion with a distal window 96, and a guidewire connector 98 coupled with a tapered distal end of shaft 94. As with previously described embodiments, shaft 94 may be flexible along its entire length, rigid along its entire length, or rigid in part and flexible in part, and may be made of any suitable material or combination of materials. In some embodiments, shaft 94 may also be steerable, such as with one or more pull wires or other steering mechanisms, for example to steer or curve a distal portion of shaft 94.
Once access device 90 is in a desired position, with window 96 facing target tissue (such as ligamentum flavum and/or facet joint bone in the spine) and an atraumatic surface of shaft 94 facing non-target tissue, any of a number of compatible tissue modification devices 100, 101, 104 or other devices may be advanced through access device 90 to perform a tissue modification procedure or other functions. Such devices may swappable in and out of access device 90 and may be in the form of cartridges, so that various cartridges may be inserted and removed as desired, over the course of a procedure. Examples of several tissue modification devices are shown in FIG. 8A, including a rongeur device 100, an ultrasound device 101 (including wire 102 and ultrasound generator 103), and an abrasive, reciprocating device 104. Further examples of tissue modification and other devices are described below with reference to FIGS. 8B-8M.
In one embodiment, for example, at least a distal portion of each tissue modification device 100, 101, 104 may be flexible, and a proximal portion of each modification device 100, 101, 104 may have a locking feature for locking into proximal handle 92 of access device 90. Thus, a given modification device, such as abrasive device 104, may be advanced into handle 92 and shaft 94, so that abrasive members 105 of device 104 are exposed through window 96 and locking feature 99 of device couples and locks within handle 92. A user may then grasp handles 34 and 92, pull up to urge abrasive members 105 against target tissue, and reciprocate access device 90 and guidewire system 10 back and forth to remove target tissue. The user may then choose to remove abrasive device 104 and insert one of the other devices 100, 101 to further modify target tissues.
In various embodiments, any of a number of tissue modification devices and/or other devices may be provided (for example as cartridges) for used with access device 90. In some embodiments, one or more of such devices may be provided with access device 90 and guidewire device 10 as a system or kit. Any given tissue modification device may act on tissue in a number of different ways, such as by cutting, ablating, dissecting, repairing, reducing blood flow in, shrinking, shaving, burring, biting, remodeling, biopsying, debriding, lysing, debulking, sanding, filing, planing, heating, cooling, vaporizing, delivering a drug to, and/or retracting target tissue. Non-tissue-modifying devices or cartridges may additionally or alternatively be provided, such as but not limited to devices for: capturing, storing and/or removing tissue; delivering a material such as bone wax or a pharmacologic agent such as thrombin, NSAID, local anesthetic or opioid; delivering an implant; placing a rivet, staple or similar device for retracting tissue; delivering a tissue dressing; cooling or freezing tissue for analgesia or to change the tissue's modulus of elasticity to facilitate tissue modification; visualizing tissue; and/or diagnosing, such as by using ultrasound, MRI, reflectance spectroscopy or the like. In given method, system or kit, any combination of tissue modification and/or non-tissue-modifying devices may be used with access device 90.
Although the example provided above describes the use of any of a number of tissue modification devices and/or other devices for used with an access device 90, these devices (also referred to as surgical devices) may also be used without an access device 90. For example, as illustrated in FIGS. 5 and 6, a surgical device may be coupled to a guidewire and inserted (via a percuateous or open route) into a patient using the guidewire without the use of an additional access device 90. In some variations, particularly those in which the internal spacing between target and non-target tissues is narrow or small, it may be better to use such devices without the additional thickness of an access device 90. Thus, in some variations, the surgical devices used as part of the guidewire systems have a relatively flat and flexible distal end region.
With reference now to FIGS. 8B-8M, distal portions of a number of exemplary embodiments of surgical devices (which may be in cartridge form in some embodiments and may be used with access device 90) are shown. FIG. 8B shows a device 430 including a sharpened, pointed, double-beveled distal tip 432. Tip 432 may be advanced across window 96 of access device 90 to cut tissue. FIG. 8C shows a device 440 including a diagonal-edge distal cutting tip 442, which may be used in a similar manner to cut tissue. FIG. 8D shows a device 450 including multiple volcano-shaped abrasive members 452. In alternative embodiments of abrasive devices, any suitable abrasive members or surfaces may be used. FIG. 8E, for example, shows a device 460 including a portion of a Gigli saw 462 attached to the device's upper surface, such as by welding. Any of a number of blades may alternatively be attached to a device, such as in the device 470 shown in FIG. 8F. Here, device 470 includes a proximally placed blade 472 having a cutting edge 474, which may be advanced across window 96 to cut tissue. FIG. 8G shows an alternative embodiment in which a device 480 includes a distally placed blade 482 with a cutting edge 484 that may be drawn back/retracted across window 96 to cut tissue. In another tissue-modifying embodiment, FIG. 8H shows a device 490 including a radiofrequency (RF) loop electrode 492 for cutting tissue and extending proximally via two insulated wires 494.
With reference to FIG. 8I, in an alternative embodiment, a device 500 may include a side-facing aperture 502 and a chamber 504. Device 500 may be advanced into access device 90 to align aperture 502 with window 96 and may then be used to collect tissue in chamber 504. Device 500 may then be removed (in some variations through access device 90) to remove the tissue from the patient. This may be repeated as many times as desired, to remove cut tissue from the patient. FIG. 8J shows a device 510 having a clamp 512 for delivering an implant 514. Implant 514, for example, may be a posterior decompression implant such as the “X-STOP” Interspinous Process Decompression™ devices offered by St. Francis Medical Technologies, Inc. (Alameda, Calif.), a foraminal implant such as that described in PCT Patent Application Pub. No. WO 2006/042206A2, or any other suitable implant for the spine or other area of the body. FIG. 8K shows an embodiment of a device 520 used for delivering a rivet (or “tissue anchor”) 524 through a distal aperture 522. In one embodiment, for example, tissue anchor 524 may be anchored to bone and used to retract ligamentum flavum tissue to increase the area of a space in the spine. Such a device is described in more detail, for example in U.S. patent application Ser. No. 11/250,332, entitled “Devices and Methods for Selective Surgical Removal of Tissue,” and filed Oct. 15, 2004, the full disclosure of which is hereby incorporated by reference.
In another embodiment, and with reference to FIG. 8L, a visualization device 530 having a visualization element 532 may be used with access device 90. Such a device may include, for example, an endoscope, fiber optics, a camera coupled with a catheter or the like. In other embodiments, ultrasound, MRI, spectroscopy or other diagnostic or visualization devices may be used. FIG. 8M shows an alternative embodiment of a device 540, which includes a distal aperture 542 through which a tissue dressing 544 may be delivered. Tissue dressing 544, for example, may include one or more fabrics, gel foam or the like. In some embodiments, one or more pharmacologic agents may be delivered through device 540. Alternatively or additionally, irrigation and/or suction may be provided through device 540. As should be apparent from the foregoing description, any suitable device, cartridge or combination of devices/cartridges may be used either with access device 90 or without a separate access device. These devices may be positioned and/or manipulated (e.g., urged against a target tissue) using the guidewire systems described herein. In addition, multiple devices may be exchanged during a procedure using the same guidewire.
Referring now to FIG. 9, another embodiment of a tissue access device 106, which may be advanced to a position in a patient's back using guidewire system 10, is shown. Tissue access device 106 may include, for example, a proximal handle 107 having a hollow bore 108 and an actuator 109, a hollow shaft 110 extending from proximal handle 107 and having a distal curved portion and a distal window 112, and a guidewire coupling member 114 coupled with a tapered distal end of shaft 110. As with the previously described embodiment, a number of different tissue modification devices 116, 117, 120 may be inserted and removed from access device 106 to perform a tissue modification procedure, such as a rongeur 116, an ultrasound device 117 (including a wire 118 and generator 119), and an abrasive device 120. In the embodiment of FIG. 9, however, handle 107 includes the additional feature of actuator 109, which may be used to activate one or more tissue modifying members of various tissue modification devices. For example, rongeur 116 may be advanced into hollow bore 108 and shaft 110, to position blades 121 of rongeur 116 so as to be exposed through window 112, and to lock a locking member 115 of rongeur 116 within handle 107. Actuator 109 may then be moved back and forth (by squeezing and releasing, in the embodiment shown) to move one or both blades 121 back and forth to cut target tissue. Optionally, rongeur 116 may then be removed from access device 106 and a different modification device 117,120 inserted to further modify target tissue. Actuator 109 may be used with some modification devices and not others. Again, in some embodiments, access device 106, guidewire system 10 and one or more modification devices 116, 117, 120 may be provided as a system or kit.
With reference now to FIG. 10, a perspective view of one embodiment of a tissue access device 240 is shown. Device 240 may include an elongate, hollow shaft 242 having a distal aperture 244, a distal extension 246 (or “platform” or “tissue shield”) extending beyond shaft 242, and a guidewire coupling member 250 attached to distal extension 246 for coupling with a guidewire 252. Both shaft 242 and distal extension 246 may be either rigid or flexible, in various embodiments. In the embodiment shown, distal extension 246 includes multiple flexibility slits 248 to enhance flexibility of that portion of device 240. Shaft 242, distal extension 246 and guidewire coupling member 250 may be made of any suitable material (or materials), and may be made from one piece of material as a single extrusion or from separate pieces attached together, in alternative embodiments. Suitable materials include, for example, metals, polymers, ceramics, or composites thereof. Suitable metals may include, but are not limited to, stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, Elgiloy™ (Elgin Specialty Metals, Elgin, Ill., USA), Conichrome™ (Carpenter Technology, Reading, Pa., USA), or Phynox™ (Imphy SA, Paris, France). Suitable polymers include, but are not limited to, nylon, polyester, Dacron™, polyethylene, acetal, Delrin™ (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Ceramics may include, but are not limited to, aluminas, zirconias, and carbides.
In addition to various materials, tissue access device 240 may have any desired combination of dimensions and shapes. In some embodiments, for example, shaft 242 and distal extension 246 have different cross-sectional shapes, while in other embodiments, they may have the same cross-sectional shape. Some embodiments may include additional features, such as a mechanism for changing distal extension 246 from a straight configuration to a curved configuration (such as with one or more pull wires).
Any of a number of different surgical/tissue modification devices, such as but not limited to those described in reference to FIGS. 8 and 9, may be used in conjunction with tissue access device 240. Such a tissue modification device may be used, for example, by passing the device through shaft 242, such that a portion of the device extends out of aperture 244 to perform a procedure, while distal extension 246 protects non-target tissue from harm. In various embodiments, multiple surgical devices may be passed through and used with tissue access device 240, either serially or simultaneously, depending on the configuration of access device 240 and the constraints of the operating field and anatomy.
Referring to FIG. 11, in another embodiment, a tissue access device 260 includes an elongate, hollow shaft 262, a handle 264, a distal aperture 266, and a distal extension 270 having flexibility slits 268 and coupled with a guidewire coupling member 272, which may be coupled with a guidewire 274. This embodiment of tissue access device 260 is similar to the one described immediately above but includes the additional feature of handle 264, which in some embodiments may be used to actuate one or more surgical/tissue modification devices passed through access device 260.
FIG. 12 depicts another alternative embodiment of a tissue access device 280, including a proximal shaft portion 282, a distal shaft portion 286, and a handle 284. Distal shaft portion 286 includes a window 288, through which a portion of a surgical/tissue modification device may be exposed to perform a procedure, and a guidewire coupling member 290, which may be coupled with a guidewire 292. As with the previously described embodiments, any of a number of surgical devices may be passed through and used with tissue access device 280, according to various embodiments. Tissue modifying portions of such devices may be exposed through or may even extend out of window 288 to perform any of a number of procedures, while distal shaft portion 286 otherwise protects non-target tissue from damage. In various embodiments, shaft portions 282, 286 may both be flexible, both be rigid, or one may be flexible and the other rigid. In one embodiment, for example, shaft 282, 286 may comprise a flexible catheter, while in an alternative embodiment, shaft 282, 286 may comprise a rigid, probe-like structure.
Any of the embodiments described in FIGS. 10-12 may further optionally include one or more external support devices, which removably attach to shaft 242, 262, 282 and one or more stabilizing structures outside the patient, such as a retractor, bed rail, or the like. Such support devices, such as detachable support arms, may be provided with a tissue access device 240, 260, 280 as part of a system or kit and may be used to help support/stabilize the access device during use.
Coupling Members
As mentioned, in general, a coupling member on (or near) the proximal end of a guidewire mates with the coupling member on (or near) the distal end of a surgical device. The coupling members may be complimentary; for example, the device coupling member on the guidewire may be received by a guidewire coupling member on the device. Coupling members may be configured to lock securely together. Coupling members may be configured so that reasonably high pulling forces (e.g., pulling on the distal end of the guidewire and/or the proximal end of the surgical device) can be handled without breaking or de-coupling the coupling members. In some variations the coupling members are configured to lock together permanently or temporarily. For example, a coupling member may be configured to secure together until adequate force is applied to separate them.
With reference now to FIGS. 13A-13D, one embodiment of a surgical device distal portion 138 with a guidewire coupling member 130 is shown in conjunction with a shaped guidewire 134. Guidewire coupling member 130 may generally include a slit 131 and a bore 132. Guidewire 134 may include a device coupling member formed as a shaped member 136 at one end, which is shown as a ball-shaped member 136 but may have any of a number of suitable shapes in alternative embodiments. Generally, guidewire 134 and shaped member 136 may be made of any suitable material, such as but not limited to any of a number of metals, polymers, ceramics, or composites thereof. Suitable metals, for example, may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, Elgiloy™ (Elgin Specialty Metals, Elgin, Ill., USA), Conichrome™ (Carpenter Technology, Reading, Pa., USA), or Phynox™ (Imphy SA, Paris, France). Suitable polymers include but are not limited to nylon, polyester, Dacron™, polyethylene, acetal, Delrin™ (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Ceramics may include but are not limited to aluminas, zirconias, and carbides. Shaped member 136 may be formed by attaching a separate member to one end of guidewire 134, such as by welding, or may be formed out of the guidewire material itself.
In the embodiment shown, guidewire 134 may be coupled with coupling member 130 by first placing guidewire 134 through slit 131 into bore 132, as shown in perspective view FIG. 13A and top view FIG. 13C. Guidewire 134 may then be pulled through bore 132 (solid-tipped arrows in FIGS. 13A and 13C), to pull shaped member 136 into bore 132, as shown in perspective view FIG. 13B and top view FIG. 13D. As visible in FIGS. 13B and 13D, bore 132 may be tapered, so that shaped member 136 may enter bore 132 but may only travel partway through before reaching a diameter of bore 132 through which it cannot pass. In an alternative embodiment, bore 132 may include a hard stop rather than a taper. In any case, shaped member 136 may be pulled into bore 132 to cause it to lodge there, and additional pulling or tensioning force may be applied to guidewire 134 without risk of pulling shaped member 136 farther through bore 132. Guidewire 134 may thus be used to pull surgical device 138 through tissue and into a desired position for performing a procedure, and may further be used to apply tensioning/pulling force to surgical device 138 to help urge a tissue modifying portion of device 138 against target tissues.
As with many of the embodiments described previously and hereafter, guidewire coupling member 130 may be either attached to or formed as an integral part of surgical device distal portion 138, according to various embodiments. Coupling member 130 may be made of any suitable material, as has been mentioned previously, and may have any desired dimensions and any of a number of different configurations, some of which are described in further detail below. In various embodiments, coupling member 130 may be attached to an extreme distal end of surgical device 138 or may be positioned at or near the extreme distal end. Although coupling member 130 is typically attached to or extending from a top or upper surface of surgical device 138, in some embodiments it may alternatively be positioned on a bottom/lower surface or other surface.
In another embodiment, and with reference now to FIGS. 14A and 14B, a guidewire coupling member 140 including a slit 142 with one or more curves 144 and a bore 143 may be attached to a surgical device distal portion 148. A guidewire 146 having a cylindrical shaped member 147 at one end may be placed through slit 142 into bore 143 and pulled distally (solid-tipped arrow), as shown in FIG. 14A. When shaped member 147 is pulled into bore 143, it is stopped by, and cannot pass through, curves 144, thus allowing guidewire 146 to be used to pull device 148 into place between target and non-target tissues and apply tensioning force.
Referring to FIGS. 15A-15F, an alternative embodiment of a guidewire coupling member 150 is shown with a shaped guidewire 158. Guidewire coupling member 150 may include a transverse slit 152, an axial channel 154 and a transverse bore 156. FIG. 15E shows a front perspective view of coupling member 150, where member 150 would be mounted on a surgical device such that a front side 151 would face distally and a back side 153 would face proximally. FIG. 15F shows a rear perspective view of coupling member 150 with back side 153 and front side 151.
FIG. 15A is a rear/left perspective view, and FIG. 15B is a top view, both showing guidewire 158 with a ball-shaped member 159 being placed through transverse slit 152 into channel 154. Channel 154 is generally an open portion within coupling member 150, having a diameter similar to or the same as that of slit 152, to allow guidewire 158 to be rotated through coupling member 150, as depicted by the solid-tipped, curved arrow in FIGS. 15A and 15B. Bore 159 is sized to allow ball-shaped member 159 (forming the device coupling member of the guidewire) to travel into it to rest within coupling member 150, as shown in FIGS. 15C and 15D. Ball-shaped member 159 is sized such that, when shaped guidewire 158 is rotated into position within coupling member 150, it cannot travel through channel 154, and is thus trapped within bore 156. Guidewire 158 may thus be pulled, to pull a device into position and/or to apply tension to the device, without guidewire 158 pulling out of coupling member 150. Guidewire 158 may be disengaged from coupling member 150 by rotating guidewire 158, coupling member 150 or both, to release shaped member 159 from bore 156. In one embodiment, coupling member 150 may be attached to a top surface of a distal portion of a surgical device, such as by welding, adhesive or other attachment means.
An alternative embodiment of a guidewire coupling member 160 is depicted in FIGS. 16A-16E. In this embodiment, guidewire coupling member 160 includes a channel 162, a central bore 164 and a side channel, as shown in perspective view FIG. 16A, top view FIG. 16B and side view FIG. 16C. Channel 162 is generally shaped and sized to allow a shaped member 169 of a guidewire 168 to pass longitudinally therethrough. Central bore 164 is shaped and sized to allow shaped member 169 to rotate within bore 164. Side channel 166 is shaped and sized to allow guidewire 168 to pass therethrough when guidewire 168 is rotated about an axis through shaped member 169. An angle 165 formed by channel 162 and an opposite end of side channel 166 may be any desired angle, in various embodiments. For example, the angle in the embodiment shown (best seen in FIGS. 16B, 16D and 16E) is approximately 90 degrees. In alternative embodiments, the angle could instead be less than 90 degrees or greater than 90 degrees. In one embodiment, for example, an angle of about 135 degrees may be used, while in another embodiment, an angle of about 180 degrees may be used.
As depicted in FIG. 16D, shaped member 169 of guidewire 168 may be passed through channel 162 and into central bore 164 (hollow-tipped arrow). Guidewire 168 may then be rotated about an axis approximately through shaped member 169 (solid-tipped, curved arrow). When rotated, guidewire 168 passes through side channel 166 to its end, as shown in FIG. 16E. Guidewire 168 may then be pulled, to pull a device attached to coupling member 160 to a desired position in a patient's body, such as between target and non-target tissues. Rotated shaped member 169 is trapped within central bore 164, due to its shape and size, and cannot pass into either side channel 166 or channel 162. To remove guidewire 168 from coupling member 160, guidewire 168 may be rotated back to the position shown in FIG. 16D and withdrawn from coupling member 160 through channel 162.
Referring now to FIGS. 17A-17D, another alternative embodiment of a guidewire coupling member 170 is shown. FIGS. 17A and 17B are front perspective and rear perspective views, respectively, in which a channel 172 and a side channel 174 of coupling member 170 may be seen. FIGS. 17C and 17D are top views, showing coupling member 170 with an inserted guidewire 178. As seen in FIG. 17C, guidewire 178 with a shaped distal member 179 may be advanced through channel 172 (hollow-tipped arrow), to position shaped member 179 in a central bore 176 of coupling member 170. Guidewire 178 may then be rotated through side channel 174 about an axis approximately about shaped member 179 (solid-tipped, curved arrow). As shown in FIG. 17D, guidewire 178 may be rotated until it hits an end 175 of side channel 174. Guidewire 178 may then be pulled to pull a device attached to coupling member 170, as shaped member 179 will be trapped within central bore 176, due to its shape and size. When desired, guidewire 178 may be removed from coupling member 170 by rotating guidewire 178 back to the position shown in FIG. 17C and withdrawing it through channel 172. Channel 172 may be located at any desired angle, relative to end 175 of side channel 174. In the embodiment shown, for example, the angle is approximately 135 degrees. As in the embodiment described immediately above, channel 172 is generally shaped and sized to allow shaped member 179 to pass longitudinally therethrough, central bore 176 is shaped and sized to allow shaped member 179 to rotate within bore 176, and side channel 174 is shaped and sized to allow guidewire 178 to pass therethrough when guidewire 178 is rotated.
Turning to FIGS. 18A and 18B, in another alternative embodiment, a guidewire coupling member may include a cam 300 and a stationary portion 306 (only a part of which is shown). Cam may 300 rotate about an axis 302 from an open position (FIG. 18A), which allows a guidewire 304 to pass through, to a closed position (FIG. 18B), which traps guidewire 304 against stationary portion 306. In one embodiment, cam 300 may automatically move from open to closed positions as guidewire 304 is advanced (arrow in FIG. 18A) and may move from closed to open positions as guidewire 304 is retracted. Some embodiments of a coupling member, such as that shown in FIGS. 18A and 18B, may be used with a guidewire 304 that does not have a shaped member on its proximal end. Alternatively, such a coupling member may also be used with a guidewire including a coupling member, such as a shaped region.
FIG. 19 shows an alternative embodiment of a guidewire coupling member, which includes two opposing cams 310 that rotate toward one another (curved arrows) to grip and hold a guidewire 312. As with the previous embodiment, this coupling member may be used, in various embodiments, either with a guidewire having shaped proximal end or an unshaped guidewire 312.
In the variations illustrated in FIGS. 18 and 19 only one coupling member may be used. For example, a guidewire coupling member on the surgical device may couple with the proximal end of the guidewire, even if the guidewire does not include an additional coupling member (e.g., a shaped region or other coupling member).
Referring now to FIGS. 20A-20C, in another embodiment, a guidewire coupling member 320 (shown in top view) may include three movable rollers 322. In an open position, as in FIG. 20A, rollers 322 may be arrayed to allow a guidewire 324 to pass through them. Rollers 322 may be moved, relative to one another (solid-tipped arrows), to partially constrain guidewire 324 (FIG. 20B) or to completely constrain guidewire 324 (FIG. 20C). Rollers 322 may be moved back to the open position (FIG. 20A) to release guidewire 324.
In an alternative embodiment, and referring now to FIGS. 21A-21C, a guidewire coupling member 330 may include a multi-piece cone 332 having a core 334 with a textured inner surface 335, and a stationary portion 336 having a receptacle 338 for receiving cone 332. In an open position, as in FIG. 21B, the two halves of cone 332 are separated and not wedged into receptacle 338, so that a guidewire 339 may be passed through core 334. Cone 332 may be moved to a closed position, as in FIG. 21C, to grip guidewire 339 with textured surface 335 and prevent guidewire 339 from moving further through core 334. In one embodiment, for example, as guidewire 339 moves through core 334, it may generate friction with textured surface 335 and thus pull cone 332 into receptacle. As with several previous embodiments, guidewire 339 may either include a proximal shaped member or may not include such a member, in various embodiments.
With reference now to FIG. 22, in another embodiment, a guidewire coupling member 340 may include a flat anvil 342 and one or more stationary portions 344. Anvil may be moved (hollow-tipped arrow) to pinch a guidewire 344 between itself and stationary portion 344.
In an alternative embodiment, shown in FIG. 23, a guidewire coupling member 350 may include a corner-pinch mechanism 352 and one or more stationary portion 354. Mechanism 352 may be advanced (hollow-tipped arrow) to pinch guidewire 356 against stationary member 354 and thus prevent it from moving further through coupling device 350.
Referring to FIG. 24, another embodiment of a guidewire coupling member 360 is shown, which includes an eccentric cam 362 that rotates (hollow-tipped arrow) to pinch a guidewire 366 between itself and a stationary portion 364.
In another embodiment, with reference to FIGS. 27A and 27B, a guidewire coupling member 390 may include multiple spools 392, through which a guidewire 394 may pass, until a shaped member 396 on one end of guidewire 394 gets caught. FIG. 27B shows coupling member 390 attached with an upper surface of a surgical device distal end 391.
In yet another embodiment, and with reference now to FIGS. 28A and 28B, a guidewire coupling member 400 may include a semi-circular ribbon 402 having two apertures 404. With this embodiment of coupling member 400 (as well as other embodiment described herein), a textured guidewire 406 may be used. As textured guidewire 406 passes through apertures 404, friction caused by the textured surface 407 causes ribbon 402 to flatten (FIG. 28B), thus trapping guidewire 406 in apertures 404. Ribbon 402 may be made of metal or any other suitable material, examples of which have been listed previously.
Referring to FIG. 29, another alternative embodiment is shown, in which a guidewire coupling member 410 includes a folded ribbon 412 having multiple apertures 414. Ribbon 412 may flatten as a textured guidewire 416 passes through it, thus causing apertures to trap guidewire 416.
Another embodiment of a guidewire coupling member 420 is shown in FIG. 30. In this embodiment, coupling member 420 includes a curved ribbon 422 with multiple apertures 424. Ribbon 422 may flatten to constrain a guidewire 426 in apertures 424, as with the previously described embodiments. Some embodiments of such ribbon-shaped coupling members 400, 410, 420 may function with a non-textured guidewire as well as, or in place of, a textured guidewire.
Referring to FIG. 31, in another embodiment, a guidewire coupling member 430 for removably coupling with a guidewire 438 may include a stationary portion 432 and a movable portion 434. Movable portion 434 may include multiple contact members 436 or locking edges, configured to hold guidewire 438 when movable portion 434 is pushed against it (hollow-tipped arrows). Movable portion 434 may be moved using any suitable technique or means in various embodiments. Contact members 436 generally press guidewire 438 against stationary portion 432 such that it will not move through coupling member 430 when pulled (solid-tipped arrow), thus allowing a device coupled with coupling member 430 to be pulled using guidewire 438.
In another embodiment, and with reference now to FIG. 32, a guidewire coupling member 440 may include a stationary portion 442 and a movable portion 444, each of which has a roughened surface 446 facing one another. Movable portion 444 may be moved toward stationary portion 442 (hollow-tipped arrows) to trap guidewire 446 in between, thus preventing guidewire 446 from moving through coupling member 440 and thus allowing a device coupled with coupling member 440 to be pulled via guidewire 448.
Turning to FIGS. 33A-33D, several alternative embodiments of a guidewire for use with various embodiments of a guidewire coupling member and guidewire system are shown. In some embodiments of a guidewire system, any of a number of currently available guidewires may be used. In other embodiments, a textured guidewire without a shaped member on either end may be used. Each of the embodiments shown in FIGS. 33A-33D, by contrast, has some kind of shaped member on a proximal end of the guidewire for coupling with a guidewire coupling member and some kind of sharpened or otherwise shaped distal tip for facilitating passage of the guidewire through tissue.
In various embodiments, guidewires may comprise a solid wire, a braided wire, a core with an outer covering or the like, and may be made of any suitable material. For example, in one embodiment, a guidewire may be made of Nitinol. In various alternative embodiments, guidewires may be made from any of a number of metals, polymers, ceramics, or composites thereof. Suitable metals, for example, may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, Elgiloy™ (Elgin Specialty Metals, Elgin, Ill., USA), Conichrome™ (Carpenter Technology, Reading, Pa., USA), or Phynox™ (Imphy SA, Paris, France). In some embodiments, materials for guidewires or for portions or coatings of guidewires may be chosen for their electrically conductive or thermally resistive properties. Suitable polymers include but are not limited to nylon, polyester, Dacron™, polyethylene, acetal, Delrin™ (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). In some embodiments, polymers may be glass-filled to add strength and stiffness. Ceramics may include but are not limited to aluminas, zirconias, and carbides.
In the embodiment shown in FIG. 33A, the guidewire 180 includes a device coupling member that is configured as a ball-like shaped member 182 at the proximal end and a pointed distal tip 184. As with all the following exemplary embodiments, shaped member 182 may be either a separate piece attached to guidewire 180 by welding or other means or may be a proximal end of guidewire 180, formed into shaped member 182. FIG. 33B shows a guidewire 186 with a cylindrical shaped member 188 and a beveled distal tip 190. FIG. 33C shows a guidewire 192 with a pyramidal shaped member 194 and a double-beveled distal tip 196. FIG. 33D shows a guidewire 198 with a cubic shaped member 200 and a threaded distal tip 202. In other variations (e.g., refer to FIGS. 25A-25B) the proximal end of the guidewire may include a hook for coupling with a guidewire couple.
In alternative embodiments, any of the shaped members 182,188,194, 200 may be combined with any of the distal tips 184,190, 196, 202. In yet other alternative embodiments, the shaped members and/or distal tips may have other shapes and/or sizes. Thus, the embodiments shown in FIGS. 33A-33D are provided primarily for exemplary purposes.
Referring now to FIGS. 34A and 34B, another embodiment of a guidewire 204 may include a drill-shaped distal tip 206 with a cutting edge 208. Such a drill-shaped tip 206 may facilitate passage of guidewire 204 through tissue, as shown in FIG. 34B. Guidewire 204 may be advanced through a probe 210 and through tissue (not shown) by simultaneously pushing (solid-tipped, straight arrows) and twisting (hollow-tipped, curved arrows) guidewire 204 from its proximal end. Drill-shaped tip 206 may facilitate passage of guidewire 204 through tissue by acting as a drill.
FIGS. 37 and 38A-38C illustrate another variation of an exchange system including a guidewire and a surgical device having a distal guidewire coupling exchange tip (“Rx” or exchange tip). In this variation the guidewire coupling member is configured to engage the proximal end of the guidewire, which is configured as a device coupling member having a cylindrical-shaped member. FIGS. 38A and 38B illustrate the coupling of the proximal end of the guidewire and the distal end of the device. In this variation, the two coupling regions are configured to lock when engaged, so that they may not be separated without the proper orientation and/or application of force. As illustrated in FIG. 38C, the opening in the guidewire coupling member has a diameter “A” that is greater than the diameter of the short axis (“B”) of the distal end of the coupling member on the guidewire, but smaller than the longitudinal axis (“C”) of the device coupling member on the guidewire. When the device coupling member of the guidewire is inserted in the opening in the guidewire coupling member of the device, and tension is applied (pulling the guidewire distal to the coupling member so that it extends in the slot of the guidewire coupling member), the guidewire and the device are locked together, and cannot be separated (even when tension is removed) without properly orienting the two so that the small diameter (“B”) of the coupling member can exit the opening of the guidewire coupling member.
FIGS. 39A-39D illustrate a very similar variation, in which the device coupling member on the proximal end of the guidewire may be permanently secured in the guidewire coupling member. In this example, the device coupling member of the guidewire has a conical, triangular or pyramidal shape in which the proximal end tapers distally so that as the proximal end of the guidewire is pulled into the guidewire coupling member of the surgical device, it become wedged and locked into the coupling member, as illustrated in FIG. 39D. Other variations of locking coupling members may be used, including releasably and permanently locking members.
FIGS. 40A-40C illustrate another variation of a locking guidewire exchange system. In this variation the proximal end of the guidewire is configured as a loop or eyelet, and the distal end of the surgical device is configured as a hook having a progressively thicker cross-section. The very proximal end of the hook may be flanged away from the body slightly, allowing the loop or eyelet to more easily engage the hook. The thinner region at the proximal end may be more flexible, so that the look or eyelet can be pulled into the hook region by deflecting the thinner portion away from the longitudinal axis sufficiently to allow the loop to pass into the hook region. Thus, the hook may be referred to as a “spring clip” hook. The guidewire may be released from the device by applying appropriate force to pull the loop out of the spring clip hook.
Another locking variation of a guidewire exchange system is shown in FIGS. 41A-41C. In this example, the guidewire coupling member on the device is configured as a coil or spring into which the guidewire may be inserted. The walls of the spring region may be tapered slightly to guide insertion. Pushing the guidewire into the coupling member may expand the spring slightly, whereas applying a tensioning force (e.g., by pulling on either or both the proximal end of the device and distal end of the guidewire) will tighten the connection between the guidewire and the device. In some variations the guidewire also include a coupling member which may be one or more regions (e.g., rings, ridges, bumps, etc.) that can fit between the loops or coils of the guidewire coupling member on the device.
FIGS. 42A-42C, 43A-43B, and 44A-44C illustrate other variations of locking or lockable guidewire exchange systems. In all of these exchange systems the guidewire may be secured to a first surgical device, and tension may be applied (e.g., to pull the device into position using the guidewire, and/or to urge the device against the target tissue). The devices may then be de-coupled from the guidewire (e.g., after the devices have been removed from the subject while leaving the guidewire in place), and another device may be coupled to the guidewire and positioned by pulling the guidewire and/or used to urge the device against the target tissue.
For example, FIG. 42A-42C illustrate a guidewire having a loop or eyelet at the proximal end coupling with a guidewire coupling region of a surgical device that is configured as a clasp. The clasp includes jaws that may move to close over the eyelet, securing it on a hook or post in the guidewire coupling region. In the example shown in FIGS. 43A and 43B, the proximal end of the guidewire is threaded and may be screwed into the guidewire coupling member of a surgical device, shown in cross section in FIG. 43B. Finally, in FIGS. 44A-44C the guidewire coupling member of a surgical device includes a sliding lock may be used to secure a hinged jaw closed over the proximal end of a guidewire. The lock may be slid proximally to unlock the hinged jaw and release the guidewire.
FIGS. 45A and 45B illustrate another variation of a spring-locking guidewire coupling region on a surgical device that mates with the device coupling region on a guidewire. In this example, a spring in the guidewire coupling member pushes one or more wedge locks distally. The spring and wedge locks can be displaced by pushing the proximal end of the guidewire into the coupling member proximally, but pulling distally only provides additional force to lock the guidewire in the coupling member. A lock release mechanism (e.g., pulling the spring or wedge locks proximally) may be included to allow release of the guidewire.
With reference to FIG. 35A, in some embodiments, a guidewire system may include a guidewire handle 220 for grasping a guidewire outside the patient. Such a guidewire handle 220 may include, for example, a guidewire clamping mechanism 222 housed in a central, longitudinal bore 221 of handle 220 and including a central guidewire aperture 223. Handle 220 may also include a lock lever 224 for tightening clamping mechanism 222 around a guidewire. At some points in the present application, handles similar to handle 220 are referred to as “distal handles,” and handles coupled with various tissue modification devices are referred to as “proximal handles.” These terms, “distal” and “proximal,” are generally used to distinguish the two types of handles and to denote that one is more proximal than the other, during use, to a first incision or entry point into a patient, through which a guidewire system is placed and then used to pull a tissue modification device into position in the patient. “Distal” and “proximal,” however, are used merely for clarification and do not refer to the relation of any device to specific anatomical structures, the position of a physician/user of the described devices/systems, or the like. Thus, in various embodiments, either type of handle may be “distal” or “proximal” relative to various structures, users or the like. For the purposes of FIGS. 35A and 35B, the embodiment is described as guidewire handle 220, denoting its function of holding a guidewire.
FIG. 35B provides an exploded view guidewire handle 220. A handle body 225 may be made of any suitable material and have any desired shape and size. In various alternative embodiments, for example, handle body 220 may be made from any of a number of metals, polymers, ceramics, or composites thereof. Suitable metals, for example, may include but are not limited to stainless steel (303, 304, 316, 316L), nickel-titanium alloy, tungsten carbide alloy, or cobalt-chromium alloy, for example, Elgiloy™ (Elgin Specialty Metals, Elgin, Ill., USA), Conichrome™ (Carpenter Technology, Reading, Pa., USA), or Phyno (Imphy SA, Paris, France). Suitable polymers include but are not limited to nylon, polyester, Dacron™, polyethylene, acetal, Delrin™ (DuPont, Wilmington, Del.), polycarbonate, nylon, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Ceramics may include but are not limited to aluminas, zirconias, and carbides.
Clamping mechanism 222 may include, for example, a snap ring 226, a keeper washer 228, a flat anvil 230, and a cage barrel 232, all of which fit within central bore 221 of handle body 225. Lock lever 224 may be coupled with a pinch screw 234 and a shoulder screw 236. When lock lever 224 is turned in one direction, it pushes shoulder screw 236 against clamping mechanism 222 to cause mechanism 222 to clamp down on a guidewire. Lock lever 224 may be turned in an opposite direction to loosen clamping mechanism 222, thus allowing a guidewire to be introduced into or release from central guidewire aperture 223.
FIGS. 36A-36B illustrate one method of using an exchange system as described. For example, FIG. 36A shows a spinal region including a neural foramen into which a cannulated probe (curve cannula) has been inserted. In general, the guidewire is inserted into the tissue (e.g., through a neural foramen) so that the pathway through the tissue includes at least one (or only one) bend or curve in which the target tissue is positioned within the radius of the curve. The guidewire may be positioned by one or more access devices. For example, FIG. 36A shows positioning of a guidewire using an access cannula having an integrated curved inner cannula slidably disposed within the outer cannula. The inner curved member is extended from the distal end of the access cannula into the foramen and around the target tissue, as shown. A guidewire may then be inserted through it, so that a distal end of the guidewire (which may be sharp) extends from the patient. Either or both the cannula and the curved inner member may also include a neural localization electrode or electrodes so that the guidewire can be positioned away from the nerve. The access cannula can then be retracted and removed from the patient, leaving the guidewire behind. As illustrated in FIGS. 36B and 36C, the guidewire may then be used (as described in detail above) to pull a surgical device (e.g., a cutting device, etc.) through the body so that it is positioned relative to the target tissue. For example, the proximal end of the cannula, initially protruding from the patient, may be coupled to a surgical device, as described above. As shown in FIG. 36C, the distal end of the guidewire can then be pulled to draw the surgical device through the patient until it is positioned as desired relative to the target tissue. In some variations the positioning may be confirmed. Positioning may be confirmed by one or more of a direct visualization technique, feel (e.g., tactile feedback on the guidewire and/or surgical device), sensors on the surgical device or guidewire, depth markers on the guidewire or surgical device, or the like.
Once in position, tension may be applied to the surgical device. For example, in some variations the guidewire remains at least partially in the patient and attached to the surgical device. Tension may be applied by pulling distally on the guidewire and proximally on the surgical device, to urge the surgical device against the target tissue. The surgical device may then be moved (e.g., back and forth across the target tissue) to mechanically actuate the surgical device, or it may be otherwise actuated, as described previously. After treatment of the tissue with this first surgical device, the device may be withdrawn from the patient. For example, the device may be withdrawn by pulling it proximally out of the patient, until the proximal end of the guidewire is again outside of the patient.
The surgical device can then be exchanged on the guidewire. For example, the proximal end of the guidewire may then be de-coupled from the surgical device, and another surgical device may be coupled, as previously described. The surgical device can again be positioned adjacent to the target tissue, and the device can be urged against the target tissue. This procedure may be repeated as often as necessary until the target tissue has been treated to the desired level. As mentioned above, any appropriate surgical device may be used an applied in this way, including (but not limited to) decompression devices, measuring devices (balloons, sounds, etc.), catheters or other devices for suction and irrigation, and devices for delivering active agents (i.e., hemostatic agents such as Thrombin, steroids, or other drugs), bone wax, etc. Implants may also be positioned by pulling then through the subject using the guidewire.
Once the procedure is complete, the guidewire may be removed from the subject.
Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.

Claims (12)

1. A method of treating a patient, the method comprising:
advancing a distal end of a guidewire into the patient's body from a first site, advancing adjacent to a target tissue, and out of the body from a second site, while maintaining a proximal end of the guidewire outside the body at the first site;
coupling an end of the guidewire on or near a distal end of a surgical device outside of the body by inserting the end of the guidewire at an angle relative to the distal end of the surgical device into a channel at or near the distal end of the surgical device and rotating one or both of the end of the guidewire and the distal end of the surgical device to lock the guidewire and the surgical device together;
pulling the guidewire to guide the surgical device adjacent to the target tissue; and
withdrawing the surgical device and end of the guidewire from the patient while maintaining the guidewire within the body and de-coupling the end of the guidewire from the surgical device and coupling the end of the guidewire on or near a distal end of a second surgical device outside of the body by inserting the end of the guidewire at an angle relative to the distal end of the second surgical device into a channel at or near the distal end of the second surgical device and rotating one or both of the end of the guidewire and the distal end of the second surgical device to lock the guidewire and the second surgical device together,
wherein at least one of the surgical device and the second surgical device comprises an abrasive surface.
2. The method of claim 1, wherein the step of coupling the end of the guidewire on or near the distal end of the surgical device comprises coupling the end of the guidewire to the first or second surgical device with at least one coupling member.
3. The method of claim 1, wherein the step of coupling the end of the guidewire on or near the distal end of the surgical device comprises engaging a guidewire coupling member on the surgical device with the end of the guidewire.
4. The method of claim 1, wherein de-coupling the end of the guidewire from the surgical device further comprises rotating the end of the guidewire, the distal end of the surgical device, or both, to release a shaped member from the channel.
5. The method of claim 1, further comprising urging the surgical device against the target tissue by applying tension to either or both of the surgical device extending from the first site and the guidewire extending from the second site.
6. The method of claim 1, further comprising performing a surgical procedure on the target tissue using the surgical device.
7. The method of claim 6, wherein the step of performing a surgical procedure comprises reciprocating the surgical device by pulling on either or both of the surgical device extending from the first site and the guidewire extending from the second site.
8. A method for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body, the method comprising:
advancing a distal end of a guidewire into the patient's body, between two tissues, and out of the body, while maintaining a proximal end of the guidewire outside the body;
coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a surgical device outside of the body by inserting the proximal end of the guidewire at an angle relative to the distal end of the surgical device into a channel at or near the distal end of the surgical device and rotating one or both the proximal end of the guidewire and the distal end of the surgical device to lock the guidewire and the surgical device together;
pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position adjacent to the target tissue;
withdrawing the surgical device and distal end of the guidewire proximally from the patient while maintaining the guidewire within the body and de-coupling the proximal end of the guidewire from the surgical device and coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a second surgical device outside of the body by inserting the proximal end of the guidewire at an angle relative to the distal end of the second surgical device into a channel of the coupling member and rotating one or both the proximal end of the guidewire and the distal end of the second surgical device to lock the guidewire and the second surgical device together;
pulling the distal end of the guidewire to guide at least a portion of an abrasive surface of the second surgical device to a desired position adjacent to the target tissue.
9. The method of claim 8, further comprising coupling the proximal end of the guidewire on or near the distal end of the first surgical device by coupling the proximal end of the guidewire to the first surgical device with at least one coupling member.
10. The method of claim 8, further comprising coupling the proximal end of the guidewire on or near the distal end of the first surgical device by engaging a guidewire coupling member on the first surgical device with the proximal end of the guidewire.
11. The method of claim 8, wherein de-coupling the end of the guidewire from the surgical device further comprises rotating the end of the guidewire, the distal end of the surgical device, or both, to release a shaped member from the channel.
12. A method for performing a procedure on a target tissue in a patient's body, the method comprising:
coupling a proximal end of a guidewire with at least one coupling member on or near a distal end of a surgical device outside of the body by inserting the proximal end of the guidewire at an angle relative to the distal end of the surgical device into a channel at or near the distal end of the surgical device;
pulling a distal end of the guidewire to guide at least a portion of the surgical device to a desired position between two tissues, such that an abrasive portion of the surgical device faces the target tissue and an atraumatic portion of the surgical device faces non-target tissue;
performing a procedure on the target tissue by reciprocating the surgical device by applying tension to both a portion of the guidewire outside of the body and a proximal portion of the surgical device; and
withdrawing the surgical device and proximal end of the guidewire from the patient while maintaining the guidewire within the body and de-coupling the proximal end of the guidewire from the surgical device, and coupling the proximal end of the guidewire on or near a distal end of a second surgical device outside of the body by inserting the proximal end of the guidewire at an angle relative to the distal end of the second surgical device into a channel at or near the distal end of the second surgical device.
US12/127,535 2004-10-15 2008-05-27 Guidewire exchange systems to treat spinal stenosis Active 2028-08-09 US8257356B2 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
US12/127,535 US8257356B2 (en) 2004-10-15 2008-05-27 Guidewire exchange systems to treat spinal stenosis
US12/816,729 US20100331883A1 (en) 2004-10-15 2010-06-16 Access and tissue modification systems and methods
US12/984,162 US9247952B2 (en) 2004-10-15 2011-01-04 Devices and methods for tissue access
US13/588,969 US8568416B2 (en) 2004-10-15 2012-08-17 Access and tissue modification systems and methods
US13/757,599 US9125682B2 (en) 2005-10-15 2013-02-01 Multiple pathways for spinal nerve root decompression from a single access point
US14/064,085 US9320618B2 (en) 2004-10-15 2013-10-25 Access and tissue modification systems and methods
US14/816,813 US9492151B2 (en) 2005-10-15 2015-08-03 Multiple pathways for spinal nerve root decompression from a single access point
US14/969,691 US9463041B2 (en) 2004-10-15 2015-12-15 Devices and methods for tissue access

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US61930604P 2004-10-15 2004-10-15
US62286504P 2004-10-28 2004-10-28
US68171905P 2005-05-16 2005-05-16
US68186405P 2005-05-16 2005-05-16
US68519005P 2005-05-27 2005-05-27
US11/251,199 US8192435B2 (en) 2004-10-15 2005-10-15 Devices and methods for tissue modification
US11/468,247 US7857813B2 (en) 2006-08-29 2006-08-29 Tissue access guidewire system and method
US12/127,535 US8257356B2 (en) 2004-10-15 2008-05-27 Guidewire exchange systems to treat spinal stenosis

Related Parent Applications (3)

Application Number Title Priority Date Filing Date
US11/251,199 Continuation-In-Part US8192435B2 (en) 2004-10-15 2005-10-15 Devices and methods for tissue modification
US11/468,247 Continuation-In-Part US7857813B2 (en) 2004-10-15 2006-08-29 Tissue access guidewire system and method
US13/588,969 Continuation-In-Part US8568416B2 (en) 2004-10-15 2012-08-17 Access and tissue modification systems and methods

Related Child Applications (3)

Application Number Title Priority Date Filing Date
US11/468,247 Continuation-In-Part US7857813B2 (en) 2004-10-15 2006-08-29 Tissue access guidewire system and method
US12/984,162 Continuation-In-Part US9247952B2 (en) 2004-10-15 2011-01-04 Devices and methods for tissue access
US13/588,969 Continuation-In-Part US8568416B2 (en) 2004-10-15 2012-08-17 Access and tissue modification systems and methods

Publications (2)

Publication Number Publication Date
US20080275458A1 US20080275458A1 (en) 2008-11-06
US8257356B2 true US8257356B2 (en) 2012-09-04

Family

ID=39940095

Family Applications (1)

Application Number Title Priority Date Filing Date
US12/127,535 Active 2028-08-09 US8257356B2 (en) 2004-10-15 2008-05-27 Guidewire exchange systems to treat spinal stenosis

Country Status (1)

Country Link
US (1) US8257356B2 (en)

Cited By (467)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010009093A2 (en) 2008-07-14 2010-01-21 Baxano, Inc Tissue modification devices
US20120080479A1 (en) * 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge comprising multiple layers
US20130037596A1 (en) * 2011-08-10 2013-02-14 Brian W. Bear Device for applying adjunct in endoscopic procedure
US8568416B2 (en) 2004-10-15 2013-10-29 Baxano Surgical, Inc. Access and tissue modification systems and methods
US8763875B2 (en) 2006-09-29 2014-07-01 Ethicon Endo-Surgery, Inc. End effector for use with a surgical fastening instrument
US8845637B2 (en) 2006-08-29 2014-09-30 Baxano Surgical, Inc. Tissue access guidewire system and method
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US8911471B2 (en) 2006-03-23 2014-12-16 Ethicon Endo-Surgery, Inc. Articulatable surgical device
US8925788B2 (en) 2007-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. End effectors for surgical stapling instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8978954B2 (en) 2010-09-30 2015-03-17 Ethicon Endo-Surgery, Inc. Staple cartridge comprising an adjustable distal portion
US8991677B2 (en) 2008-02-14 2015-03-31 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US9072515B2 (en) 2008-02-14 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US20150190149A1 (en) * 2014-01-09 2015-07-09 Zyga Technology, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9113874B2 (en) 2006-01-31 2015-08-25 Ethicon Endo-Surgery, Inc. Surgical instrument system
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9125682B2 (en) 2005-10-15 2015-09-08 Amendia, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9131940B2 (en) 2010-09-29 2015-09-15 Ethicon Endo-Surgery, Inc. Staple cartridge
US9138225B2 (en) 2007-06-22 2015-09-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9204878B2 (en) 2008-02-14 2015-12-08 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US9283054B2 (en) 2013-08-23 2016-03-15 Ethicon Endo-Surgery, Llc Interactive displays
US9282966B2 (en) 2004-07-28 2016-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9301759B2 (en) 2006-03-23 2016-04-05 Ethicon Endo-Surgery, Llc Robotically-controlled surgical instrument with selectively articulatable end effector
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9307986B2 (en) 2013-03-01 2016-04-12 Ethicon Endo-Surgery, Llc Surgical instrument soft stop
US9307988B2 (en) 2005-08-31 2016-04-12 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US9314253B2 (en) 2008-07-01 2016-04-19 Amendia, Inc. Tissue modification devices and methods
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9320521B2 (en) 2006-06-27 2016-04-26 Ethicon Endo-Surgery, Llc Surgical instrument
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9326768B2 (en) 2005-08-31 2016-05-03 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US9326769B2 (en) 2006-01-31 2016-05-03 Ethicon Endo-Surgery, Llc Surgical instrument
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
US9345491B2 (en) 2004-10-15 2016-05-24 Amendia, Inc. Flexible tissue rasp
US9351741B2 (en) 2006-05-04 2016-05-31 Amendia, Inc. Flexible tissue removal devices and methods
US9358005B2 (en) 2010-09-30 2016-06-07 Ethicon Endo-Surgery, Llc End effector layer including holding features
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9370364B2 (en) 2008-10-10 2016-06-21 Ethicon Endo-Surgery, Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US9370358B2 (en) 2006-01-31 2016-06-21 Ethicon Endo-Surgery, Llc Motor-driven surgical cutting and fastening instrument with tactile position feedback
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US9393015B2 (en) 2009-02-06 2016-07-19 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with cutting member reversing mechanism
US9456829B2 (en) 2004-10-15 2016-10-04 Amendia, Inc. Powered tissue modification devices and methods
US9463029B2 (en) 2007-12-07 2016-10-11 Amendia, Inc. Tissue modification devices
US9486214B2 (en) 2009-02-06 2016-11-08 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with switching system configured to prevent firing initiation until activated
US9522029B2 (en) 2008-02-14 2016-12-20 Ethicon Endo-Surgery, Llc Motorized surgical cutting and fastening instrument having handle based power source
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US9603598B2 (en) 2007-01-11 2017-03-28 Ethicon Endo-Surgery, Llc Surgical stapling device with a curved end effector
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US9655614B2 (en) 2008-09-23 2017-05-23 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument with an end effector
US9690362B2 (en) 2014-03-26 2017-06-27 Ethicon Llc Surgical instrument control circuit having a safety processor
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
US9724098B2 (en) 2012-03-28 2017-08-08 Ethicon Endo-Surgery, Llc Staple cartridge comprising an implantable layer
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US9743929B2 (en) 2014-03-26 2017-08-29 Ethicon Llc Modular powered surgical instrument with detachable shaft assemblies
US9743928B2 (en) 2006-01-31 2017-08-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US9757123B2 (en) 2007-01-10 2017-09-12 Ethicon Llc Powered surgical instrument having a transmission system
US9795382B2 (en) 2005-08-31 2017-10-24 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9814462B2 (en) 2010-09-30 2017-11-14 Ethicon Llc Assembly for fastening tissue comprising a compressible layer
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US9826978B2 (en) 2010-09-30 2017-11-28 Ethicon Llc End effectors with same side closure and firing motions
US9833241B2 (en) 2014-04-16 2017-12-05 Ethicon Llc Surgical fastener cartridges with driver stabilizing arrangements
US9839427B2 (en) 2005-08-31 2017-12-12 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and a staple driver arrangement
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
WO2018009718A1 (en) * 2016-07-06 2018-01-11 Revive Medical, LLC Methods and devices for valve clip excision
US9895147B2 (en) 2005-11-09 2018-02-20 Ethicon Llc End effectors for surgical staplers
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US9931118B2 (en) 2015-02-27 2018-04-03 Ethicon Endo-Surgery, Llc Reinforced battery for a surgical instrument
US9931141B2 (en) 2014-11-26 2018-04-03 Ex Technology, Llc Method and apparatus for joint fusion
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US10004498B2 (en) 2006-01-31 2018-06-26 Ethicon Llc Surgical instrument comprising a plurality of articulation joints
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US10052102B2 (en) 2015-06-18 2018-08-21 Ethicon Llc Surgical end effectors with dual cam actuated jaw closing features
US10052044B2 (en) 2015-03-06 2018-08-21 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US10058963B2 (en) 2006-01-31 2018-08-28 Ethicon Llc Automated end effector component reloading system for use with a robotic system
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10098642B2 (en) 2015-08-26 2018-10-16 Ethicon Llc Surgical staples comprising features for improved fastening of tissue
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
US10172620B2 (en) 2015-09-30 2019-01-08 Ethicon Llc Compressible adjuncts with bonding nodes
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10206676B2 (en) 2008-02-14 2019-02-19 Ethicon Llc Surgical cutting and fastening instrument
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10226249B2 (en) 2013-03-01 2019-03-12 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10245029B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instrument with articulating and axially translatable end effector
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10258336B2 (en) 2008-09-19 2019-04-16 Ethicon Llc Stapling system configured to produce different formed staple heights
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10265065B2 (en) 2013-12-23 2019-04-23 Ethicon Llc Surgical staples and staple cartridges
US10271849B2 (en) 2015-09-30 2019-04-30 Ethicon Llc Woven constructs with interlocked standing fibers
US10278780B2 (en) 2007-01-10 2019-05-07 Ethicon Llc Surgical instrument for use with robotic system
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
US10293100B2 (en) 2004-07-28 2019-05-21 Ethicon Llc Surgical stapling instrument having a medical substance dispenser
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10363037B2 (en) 2016-04-18 2019-07-30 Ethicon Llc Surgical instrument system comprising a magnetic lockout
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10376263B2 (en) 2016-04-01 2019-08-13 Ethicon Llc Anvil modification members for surgical staplers
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10398433B2 (en) 2007-03-28 2019-09-03 Ethicon Llc Laparoscopic clamp load measuring devices
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US10413294B2 (en) 2012-06-28 2019-09-17 Ethicon Llc Shaft assembly arrangements for surgical instruments
US10420549B2 (en) 2008-09-23 2019-09-24 Ethicon Llc Motorized surgical instrument
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US10426481B2 (en) 2014-02-24 2019-10-01 Ethicon Llc Implantable layer assemblies
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10433890B2 (en) 2015-03-25 2019-10-08 Coracoid Solutions, Llc Joint repair system
US10448950B2 (en) 2016-12-21 2019-10-22 Ethicon Llc Surgical staplers with independently actuatable closing and firing systems
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10463370B2 (en) 2008-02-14 2019-11-05 Ethicon Llc Motorized surgical instrument
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US10492785B2 (en) 2016-12-21 2019-12-03 Ethicon Llc Shaft assembly comprising a lockout
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10499890B2 (en) 2006-01-31 2019-12-10 Ethicon Llc Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US10499914B2 (en) 2016-12-21 2019-12-10 Ethicon Llc Staple forming pocket arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US10517596B2 (en) 2016-12-21 2019-12-31 Ethicon Llc Articulatable surgical instruments with articulation stroke amplification features
US10537325B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Staple forming pocket arrangement to accommodate different types of staples
US10537324B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Stepped staple cartridge with asymmetrical staples
US10542979B2 (en) 2016-06-24 2020-01-28 Ethicon Llc Stamped staples and staple cartridges using the same
US10568625B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US10568626B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Surgical instruments with jaw opening features for increasing a jaw opening distance
US10575868B2 (en) 2013-03-01 2020-03-03 Ethicon Llc Surgical instrument with coupler assembly
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10588633B2 (en) 2017-06-28 2020-03-17 Ethicon Llc Surgical instruments with open and closable jaws and axially movable firing member that is initially parked in close proximity to the jaws prior to firing
US10596002B2 (en) 2010-01-04 2020-03-24 Rti Surgical, Inc. Sacroiliac fusion system
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US10617418B2 (en) 2015-08-17 2020-04-14 Ethicon Llc Implantable layers for a surgical instrument
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10631859B2 (en) 2017-06-27 2020-04-28 Ethicon Llc Articulation systems for surgical instruments
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10660640B2 (en) 2008-02-14 2020-05-26 Ethicon Llc Motorized surgical cutting and fastening instrument
US10667804B2 (en) 2014-03-17 2020-06-02 Evalve, Inc. Mitral valve fixation device removal devices and methods
US10667809B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Staple cartridge and staple cartridge channel comprising windows defined therein
US10675028B2 (en) 2006-01-31 2020-06-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US10695062B2 (en) 2010-10-01 2020-06-30 Ethicon Llc Surgical instrument including a retractable firing member
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US10736628B2 (en) 2008-09-23 2020-08-11 Ethicon Llc Motor-driven surgical cutting instrument
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US10743851B2 (en) 2008-02-14 2020-08-18 Ethicon Llc Interchangeable tools for surgical instruments
USD894389S1 (en) 2016-06-24 2020-08-25 Ethicon Llc Surgical fastener
US10751076B2 (en) 2009-12-24 2020-08-25 Ethicon Llc Motor-driven surgical cutting instrument with electric actuator directional control assembly
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US10758233B2 (en) 2009-02-05 2020-09-01 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US10765424B2 (en) 2008-02-13 2020-09-08 Ethicon Llc Surgical stapling instrument
US20200281621A1 (en) * 2016-12-16 2020-09-10 Beth Israel Deaconess Medical Center, Inc. Image guided spinal decompression with contralateral oblique view
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10779824B2 (en) 2017-06-28 2020-09-22 Ethicon Llc Surgical instrument comprising an articulation system lockable by a closure system
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10925599B2 (en) 2013-12-23 2021-02-23 Ethicon Llc Modular surgical instruments
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10987102B2 (en) 2010-09-30 2021-04-27 Ethicon Llc Tissue thickness compensator comprising a plurality of layers
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US11013511B2 (en) 2007-06-22 2021-05-25 Ethicon Llc Surgical stapling instrument with an articulatable end effector
US11020109B2 (en) 2013-12-23 2021-06-01 Ethicon Llc Surgical stapling assembly for use with a powered surgical interface
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11051813B2 (en) 2006-01-31 2021-07-06 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US11071545B2 (en) 2014-09-05 2021-07-27 Cilag Gmbh International Smart cartridge wake up operation and data retention
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11123065B2 (en) 2013-12-23 2021-09-21 Cilag Gmbh International Surgical cutting and stapling instruments with independent jaw control features
US11133106B2 (en) 2013-08-23 2021-09-28 Cilag Gmbh International Surgical instrument assembly comprising a retraction assembly
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US11202633B2 (en) 2014-09-26 2021-12-21 Cilag Gmbh International Surgical stapling buttresses and adjunct materials
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US11213295B2 (en) 2015-09-02 2022-01-04 Cilag Gmbh International Surgical staple configurations with camming surfaces located between portions supporting surgical staples
US11219456B2 (en) 2015-08-26 2022-01-11 Cilag Gmbh International Surgical staple strips for permitting varying staple properties and enabling easy cartridge loading
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11224428B2 (en) 2016-12-21 2022-01-18 Cilag Gmbh International Surgical stapling systems
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11229437B2 (en) 2019-06-28 2022-01-25 Cilag Gmbh International Method for authenticating the compatibility of a staple cartridge with a surgical instrument
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11241230B2 (en) 2012-06-28 2022-02-08 Cilag Gmbh International Clip applier tool for use with a robotic surgical system
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11259799B2 (en) 2014-03-26 2022-03-01 Cilag Gmbh International Interface systems for use with surgical instruments
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US11266409B2 (en) 2014-04-16 2022-03-08 Cilag Gmbh International Fastener cartridge comprising a sled including longitudinally-staggered ramps
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11284898B2 (en) 2014-09-18 2022-03-29 Cilag Gmbh International Surgical instrument including a deployable knife
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11291449B2 (en) 2009-12-24 2022-04-05 Cilag Gmbh International Surgical cutting instrument that analyzes tissue thickness
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US11317913B2 (en) 2016-12-21 2022-05-03 Cilag Gmbh International Lockout arrangements for surgical end effectors and replaceable tool assemblies
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US11350928B2 (en) 2016-04-18 2022-06-07 Cilag Gmbh International Surgical instrument comprising a tissue thickness lockout and speed control system
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US11382627B2 (en) 2014-04-16 2022-07-12 Cilag Gmbh International Surgical stapling assembly comprising a firing member including a lateral extension
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11464513B2 (en) 2012-06-28 2022-10-11 Cilag Gmbh International Surgical instrument system including replaceable end effectors
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11478247B2 (en) 2010-07-30 2022-10-25 Cilag Gmbh International Tissue acquisition arrangements and methods for surgical stapling devices
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11523823B2 (en) 2016-02-09 2022-12-13 Cilag Gmbh International Surgical instruments with non-symmetrical articulation arrangements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
US11571215B2 (en) 2010-09-30 2023-02-07 Cilag Gmbh International Layer of material for a surgical end effector
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11622763B2 (en) 2013-04-16 2023-04-11 Cilag Gmbh International Stapling assembly comprising a shiftable drive
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11638582B2 (en) 2020-07-28 2023-05-02 Cilag Gmbh International Surgical instruments with torsion spine drive arrangements
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11678877B2 (en) 2014-12-18 2023-06-20 Cilag Gmbh International Surgical instrument including a flexible support configured to support a flexible firing member
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US11690619B2 (en) 2016-06-24 2023-07-04 Cilag Gmbh International Staple cartridge comprising staples having different geometries
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11717294B2 (en) 2014-04-16 2023-08-08 Cilag Gmbh International End effector arrangements comprising indicators
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11723662B2 (en) 2021-05-28 2023-08-15 Cilag Gmbh International Stapling instrument comprising an articulation control display
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11766259B2 (en) 2016-12-21 2023-09-26 Cilag Gmbh International Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11766260B2 (en) 2016-12-21 2023-09-26 Cilag Gmbh International Methods of stapling tissue
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11793522B2 (en) 2015-09-30 2023-10-24 Cilag Gmbh International Staple cartridge assembly including a compressible adjunct
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11826132B2 (en) 2015-03-06 2023-11-28 Cilag Gmbh International Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US11826048B2 (en) 2017-06-28 2023-11-28 Cilag Gmbh International Surgical instrument comprising selectively actuatable rotatable couplers
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11883026B2 (en) 2014-04-16 2024-01-30 Cilag Gmbh International Fastener cartridge assemblies and staple retainer cover arrangements
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11918215B2 (en) 2021-09-27 2024-03-05 Cilag Gmbh International Staple cartridge with array of staple pockets

Families Citing this family (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6907884B2 (en) 2002-09-30 2005-06-21 Depay Acromed, Inc. Method of straddling an intraosseous nerve
US7258690B2 (en) 2003-03-28 2007-08-21 Relievant Medsystems, Inc. Windowed thermal ablation probe
US8613744B2 (en) 2002-09-30 2013-12-24 Relievant Medsystems, Inc. Systems and methods for navigating an instrument through bone
US8361067B2 (en) 2002-09-30 2013-01-29 Relievant Medsystems, Inc. Methods of therapeutically heating a vertebral body to treat back pain
US8808284B2 (en) 2008-09-26 2014-08-19 Relievant Medsystems, Inc. Systems for navigating an instrument through bone
US8221397B2 (en) 2004-10-15 2012-07-17 Baxano, Inc. Devices and methods for tissue modification
US9101386B2 (en) 2004-10-15 2015-08-11 Amendia, Inc. Devices and methods for treating tissue
US7578819B2 (en) * 2005-05-16 2009-08-25 Baxano, Inc. Spinal access and neural localization
US8617163B2 (en) 2004-10-15 2013-12-31 Baxano Surgical, Inc. Methods, systems and devices for carpal tunnel release
US8062300B2 (en) 2006-05-04 2011-11-22 Baxano, Inc. Tissue removal with at least partially flexible devices
US8192435B2 (en) 2004-10-15 2012-06-05 Baxano, Inc. Devices and methods for tissue modification
US9247952B2 (en) 2004-10-15 2016-02-02 Amendia, Inc. Devices and methods for tissue access
US7738969B2 (en) 2004-10-15 2010-06-15 Baxano, Inc. Devices and methods for selective surgical removal of tissue
US8092456B2 (en) 2005-10-15 2012-01-10 Baxano, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US20080208223A1 (en) * 2007-02-26 2008-08-28 Paul Edward Kraemer Cable clamping device and method of its use
EP2194861A1 (en) 2007-09-06 2010-06-16 Baxano, Inc. Method, system and apparatus for neural localization
US8540720B2 (en) 2007-12-06 2013-09-24 Javier Garcia-Bengochea System, instrumentation and method for spinal fixation using minimally invasive surgical techniques
US20090275862A1 (en) * 2008-04-30 2009-11-05 Cook Incorporated Guidewire and method of making same
US8398641B2 (en) 2008-07-01 2013-03-19 Baxano, Inc. Tissue modification devices and methods
US8409206B2 (en) 2008-07-01 2013-04-02 Baxano, Inc. Tissue modification devices and methods
CA2957010C (en) 2008-09-26 2017-07-04 Relievant Medsystems, Inc. Systems and methods for navigating an instrument through bone
US10028753B2 (en) 2008-09-26 2018-07-24 Relievant Medsystems, Inc. Spine treatment kits
US20120109129A1 (en) * 2010-11-02 2012-05-03 Bernstein Oren S Replacement system for a surgical wire
JP5582619B2 (en) 2009-03-13 2014-09-03 バクサノ,インク. Flexible nerve position determination device
JP5702365B2 (en) * 2009-05-07 2015-04-15 日立アロカメディカル株式会社 Ultrasound system for orthopedic applications
US8394102B2 (en) 2009-06-25 2013-03-12 Baxano, Inc. Surgical tools for treatment of spinal stenosis
US8652157B2 (en) 2009-08-07 2014-02-18 Thayer Intellectual Property, Inc. Systems and methods for treatment of compressed nerves
US8348966B2 (en) 2009-08-07 2013-01-08 Thayer Intellectual Property, Inc. Systems and methods for treatment of compressed nerves
US8753364B2 (en) 2009-08-07 2014-06-17 Thayer Intellectual Property, Inc. Systems and methods for treatment of compressed nerves
US8882673B2 (en) * 2010-02-12 2014-11-11 I-Flow Corporation Continuous transversus abdominis plane block
USD673683S1 (en) 2010-09-15 2013-01-01 Thayer Intellectual Property, Inc. Medical device
USD666725S1 (en) 2010-09-15 2012-09-04 Thayer Intellectual Property, Inc. Handle for a medical device
USD674489S1 (en) 2010-09-15 2013-01-15 Thayer Intellectual Property, Inc. Handle for a medical device
US8758412B2 (en) 2010-09-20 2014-06-24 Pachyderm Medical, L.L.C. Integrated IPD devices, methods, and systems
US9265897B2 (en) 2011-01-26 2016-02-23 Avent, Inc. Method and corresponding kit for administering a paravertebral block
US9283019B2 (en) * 2011-06-08 2016-03-15 Warsaw Orthopedic, Inc. Flexible guide wire
MX365039B (en) * 2011-07-18 2019-05-21 Truminim Int Corporation Percutaneous methods for spinal stenosis and foraminal stenosis.
WO2013101772A1 (en) 2011-12-30 2013-07-04 Relievant Medsystems, Inc. Systems and methods for treating back pain
US10588691B2 (en) 2012-09-12 2020-03-17 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
CA2889478C (en) 2012-11-05 2020-11-24 Relievant Medsystems, Inc. Systems and methods for creating curved paths through bone and modulating nerves within the bone
US9724151B2 (en) 2013-08-08 2017-08-08 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
CN110730676B (en) 2017-06-15 2022-07-29 奥林巴斯株式会社 Guiding tube
JP7277602B2 (en) 2019-03-08 2023-05-19 ボストン サイエンティフィック サイムド,インコーポレイテッド Pinch lock sheath retention mechanism
EP4027912A4 (en) 2019-09-12 2023-08-16 Relievant Medsystems, Inc. Systems and methods for tissue modulation
US11672946B2 (en) 2019-09-24 2023-06-13 Boston Scientific Scimed, Inc. Protection and actuation mechanism for controlled release of implantable embolic devices
US20210290283A1 (en) * 2020-03-19 2021-09-23 Boston Scientific Scimed Inc. Navigation-Enabled Cryoablation System with Indirect Device Tracking

Citations (620)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US184804A (en) 1876-11-28 Improvement in surgical saws
US289104A (en) 1883-11-27 Combined rasp and saw
US863389A (en) 1906-06-07 1907-08-13 E N Dickerson Flexible file.
US1039487A (en) 1912-03-09 1912-09-24 Williams Patent Crusher & Pulv Abrasive.
US1201467A (en) 1915-04-26 1916-10-17 Emil J Hoglund Bone-cutting instrument.
US1374638A (en) 1920-01-06 1921-04-12 Cew Charles A De Hand power-driven band-saw
US1543195A (en) 1921-07-07 1925-06-23 Thygesen Jens Peter Nielsen Device for cutting up fetal and like objects in animals
US1690812A (en) 1927-10-08 1928-11-06 John P Benning File
US1938200A (en) 1933-12-05 Band-saw operating mechanism
US2243757A (en) 1939-11-09 1941-05-27 Continental Machines File band
US2269749A (en) 1940-09-16 1942-01-13 Continental Machines File band
US2372553A (en) 1942-06-11 1945-03-27 Continental Machines File band
US2437697A (en) 1946-04-01 1948-03-16 Kalom Lawrence Electrical probe
US2516882A (en) 1948-01-22 1950-08-01 Kalom Lawrence Electrical probe
US2704064A (en) 1952-09-10 1955-03-15 Meditron Company Neurosurgical stimulator
US2820281A (en) 1956-11-30 1958-01-21 Red Devil Tools Abrasive article
US2843128A (en) 1957-03-18 1958-07-15 Storz Instr Co Adenotome
US2982005A (en) 1952-02-06 1961-05-02 Simmonds Aerocessories Ltd Cutting and abrading machines
USRE25582E (en) 1964-05-19 D a vi es
US3150470A (en) 1961-08-11 1964-09-29 Lee H Barron Diamond coated wire saw
US3200814A (en) 1963-03-12 1965-08-17 Ellis R Taylor Apparatus for measuring reflexes, tremors and the like
US3389447A (en) 1967-05-26 1968-06-25 Theobald Elwin Omnidirectional cutting tool
US3491776A (en) 1967-06-08 1970-01-27 Floxite Co Inc Dental cleaner for the removal of tobacco and other stains from teeth
US3495590A (en) 1967-03-15 1970-02-17 Warren Zeiller Surgical cast and cast removal saw
US3528152A (en) 1966-03-17 1970-09-15 Shinnosuke Funakubo Band-type file
US3624484A (en) 1968-12-13 1971-11-30 Wellcome Foundation Ltd Inc Th Oscillator output circuit configuration
US3640280A (en) 1969-11-26 1972-02-08 Daniel R Slanker Power-driven reciprocating bone surgery instrument
US3651844A (en) 1970-02-24 1972-03-28 Terry B C Barnes All purpose saw
US3664329A (en) 1970-03-09 1972-05-23 Concept Nerve locator/stimulator
US3682162A (en) 1968-12-13 1972-08-08 Wellcome Found Combined electrode and hypodermic syringe needle
US3699729A (en) 1971-05-14 1972-10-24 Carrier Craft Corp Sanding hand tool
US3752166A (en) 1969-12-24 1973-08-14 American Filtrona Corp Tobacco smoke filter
US3774355A (en) 1971-10-15 1973-11-27 Remington Arms Co Inc Armored metal file band and production thereof
US3830226A (en) 1973-06-15 1974-08-20 Concept Variable output nerve locator
US3835859A (en) 1973-02-22 1974-09-17 R Roberts Surgical instrument
US3957036A (en) 1975-02-03 1976-05-18 Baylor College Of Medicine Method and apparatus for recording activity in intact nerves
US3956858A (en) 1973-11-23 1976-05-18 Remington Arms Company, Inc. Flexible hand held abrading tool
US3978862A (en) 1974-08-26 1976-09-07 Stryker Corporation Surgical cutting device
US3999294A (en) 1976-05-07 1976-12-28 George Shoben Flexible bladed saw
US4015931A (en) 1975-09-29 1977-04-05 Engelhard Minerals & Chemicals Corporation Bonded-abrasive wire saw
US4099519A (en) 1977-01-14 1978-07-11 Warren Fred E Diagnostic device
US4108182A (en) 1977-02-16 1978-08-22 Concept Inc. Reciprocation vitreous suction cutter head
US4160320A (en) 1977-04-06 1979-07-10 Best & Donovan Hand held band saw
US4172440A (en) 1976-03-27 1979-10-30 Hoechst Aktiengesellschaft Cutting monofilament
US4203444A (en) 1977-11-07 1980-05-20 Dyonics, Inc. Surgical instrument suitable for closed surgery such as of the knee
US4207897A (en) 1976-07-21 1980-06-17 Spembly Limited Cryosurgical probe
US4259276A (en) 1977-06-24 1981-03-31 Rawlings Derek S Hole forming
US4405061A (en) 1981-08-18 1983-09-20 National Instrument Co., Inc. Filling machine
DE3209403A1 (en) 1982-03-16 1983-09-22 M.A.N. Maschinenfabrik Augsburg-Nürnberg AG, 8000 München Device for making an excavation in a bone
USD273806S (en) 1981-08-03 1984-05-08 Zimmer, Inc. Reamer/rasp tool, with disposable, debris retaining cutting surface
US4464836A (en) 1982-09-15 1984-08-14 Hissa Robert E Friction saw and handle assembly
US4502184A (en) 1983-06-30 1985-03-05 Kentmaster Manufacturing Co., Inc. Reversible carcass saw
US4515168A (en) 1983-07-22 1985-05-07 Chester Martin H Clamp-on nerve stimulator and locator
US4518022A (en) 1982-09-29 1985-05-21 Valdes Guillermo A Oscillating cutting element
US4545374A (en) 1982-09-03 1985-10-08 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4573448A (en) 1983-10-05 1986-03-04 Pilling Co. Method for decompressing herniated intervertebral discs
US4580545A (en) 1984-02-29 1986-04-08 Florida Wire And Cable Company Stone sawing strand
US4590949A (en) 1984-11-01 1986-05-27 Cordis Corporation Neural stimulating lead with stabilizing mechanism and method for using same
US4616660A (en) 1984-12-10 1986-10-14 Suncoast Medical Manufacturing, Inc. Variable alternating current output nerve locator/stimulator
US4621636A (en) 1979-07-23 1986-11-11 Fogarty Thomas J Endarterectomy method and apparatus
US4625725A (en) 1983-08-30 1986-12-02 Snowden-Pencer, Inc. Surgical rasp and method of manufacture
US4660571A (en) 1985-07-18 1987-04-28 Cordis Corporation Percutaneous lead having radially adjustable electrode
US4678459A (en) 1984-07-23 1987-07-07 E-Z-Em, Inc. Irrigating, cutting and aspirating system for percutaneous surgery
US4690642A (en) 1984-11-09 1987-09-01 G-C Dental Industrial Corp. Dental polishing strip
US4700702A (en) 1985-12-09 1987-10-20 Tatiana Nilsson Instrument for cutting tissues in surgery
US4709699A (en) 1986-08-06 1987-12-01 Fort Wayne Metals Research Products Corporation Surgeon's Gigli saw and method
US4741343A (en) 1985-05-06 1988-05-03 Massachusetts Institute Of Technology Method and apparatus for measuring oxygen partial pressure and temperature in living tissue
US4750249A (en) 1986-09-08 1988-06-14 Richardson Henry A Pipe scraping tool
US4794931A (en) 1986-02-28 1989-01-03 Cardiovascular Imaging Systems, Inc. Catheter apparatus, system and method for intravascular two-dimensional ultrasonography
US4808157A (en) 1987-07-13 1989-02-28 Neuro Delivery Technology, Inc. Multi-lumen epidural-spinal needle
US4817628A (en) 1985-10-18 1989-04-04 David L. Zealear System and method for evaluating neurological function controlling muscular movements
US4856193A (en) 1987-07-24 1989-08-15 Grachan Ronald A Saw
US4867155A (en) 1988-06-21 1989-09-19 Nu-Tech Industries, Inc. Arthroscopic cutting device
US4872452A (en) 1989-01-09 1989-10-10 Minnesota Mining And Manufacturing Company Bone rasp
US4873978A (en) 1987-12-04 1989-10-17 Robert Ginsburg Device and method for emboli retrieval
US4883460A (en) 1988-04-25 1989-11-28 Zanetti Paul H Technique for removing deposits from body vessels
US4894063A (en) 1983-05-24 1990-01-16 Baxter International Inc. Barrier layer for implantable tendons and ligaments
US4912799A (en) 1989-01-30 1990-04-03 Coleman Jr Lewis E Water main scraper
USRE33258E (en) 1984-07-23 1990-07-10 Surgical Dynamics Inc. Irrigating, cutting and aspirating system for percutaneous surgery
US4943295A (en) 1988-07-13 1990-07-24 Hartlaub Thaddeus J Surgical cutting tool
US4946462A (en) 1988-12-12 1990-08-07 Watanabe Robert S Arthroscopic guide and method
US4957117A (en) 1988-11-03 1990-09-18 Ramsey Foundation One-handed percutaneous transluminal angioplasty steering device and method
US4962766A (en) 1989-07-19 1990-10-16 Herzon Garrett D Nerve locator and stimulator
US4973329A (en) 1988-05-16 1990-11-27 Medical Innovations Corporation Assembly of wire inserter and lock for a medical wire
US4990148A (en) 1989-01-13 1991-02-05 Codman & Shurtleff, Inc. Thin footplate rongeur
US4994072A (en) 1988-08-31 1991-02-19 Meadox Medicals, Inc. Dilation catheter
US4994036A (en) 1988-09-09 1991-02-19 B. Braun Melsungen Ag Catheter set for spinal anaesthesia
US4995200A (en) 1990-02-27 1991-02-26 Edward Eberhart Sanding tool
US5019082A (en) 1987-01-08 1991-05-28 Sulzer Brothers Limited Rasp-like reaming instrument
US5025787A (en) 1986-10-08 1991-06-25 The Imperial College Of Science, Technology & Medicine Intrauterine probe
US5026386A (en) 1988-12-23 1991-06-25 Michelson Gary K Flaval separator
US5026379A (en) 1989-12-05 1991-06-25 Inbae Yoon Multi-functional instruments and stretchable ligating and occluding devices
US5078137A (en) 1986-05-05 1992-01-07 Massachusetts Institute Of Technology Apparatus for measuring oxygen partial pressure and temperature, in living tissue
US5089003A (en) 1989-12-22 1992-02-18 Zimmer, Inc. Rasp tool including detachable handle member
US5100424A (en) 1990-05-21 1992-03-31 Cardiovascular Imaging Systems, Inc. Intravascular catheter having combined imaging abrasion head
US5108403A (en) 1990-11-09 1992-04-28 Stern Mark S Bone waxing device
DE4036804A1 (en) 1990-11-19 1992-05-21 Univ Halle Wittenberg Instruments for decompression of cervical narrow spinal channel - act to remove dorsal edge points of vertebrae and ventral bridge building of damaged segments
US5125928A (en) 1989-04-13 1992-06-30 Everest Medical Corporation Ablation catheter with selectively deployable electrodes
US5147364A (en) 1981-08-20 1992-09-15 Ohio Medical Instrument Company Osteotomy saw/file, cutting guide and method
US5152749A (en) 1991-06-28 1992-10-06 American Medical Systems, Inc. Instrument placement apparatus
US5161534A (en) 1991-09-05 1992-11-10 C. R. Bard, Inc. Tool for manipulating a medical guidewire
US5163939A (en) 1991-06-27 1992-11-17 Frederick Winston Disk flow and methods therefor
US5176649A (en) 1991-01-28 1993-01-05 Akio Wakabayashi Insertion device for use with curved, rigid endoscopic instruments and the like
US5178161A (en) 1988-09-02 1993-01-12 The Board Of Trustees Of The Leland Stanford Junior University Microelectronic interface
US5178145A (en) 1991-07-24 1993-01-12 Rea James L Self retaining laryngeal surface electrode and method for independent identification of human recurrent laryngeal nerve
US5191888A (en) 1990-04-18 1993-03-09 Cordis Corporation Assembly of an extension guidewire and an alignment tool for same
US5195507A (en) 1990-11-06 1993-03-23 Ethicon, Inc. Endoscopic surgical instrument for displacing tissue or organs
US5201704A (en) 1989-11-07 1993-04-13 Ray Joel W Method of making and using a hemostatic agent applicator
US5215105A (en) 1989-11-14 1993-06-01 Custom Medical Concepts, Inc. Method of treating epidural lesions
US5219358A (en) 1991-08-29 1993-06-15 Ethicon, Inc. Shape memory effect surgical needles
US5234435A (en) 1991-03-08 1993-08-10 Seagrave Jr Richard A Surgical method and apparatus
US5242418A (en) 1992-05-22 1993-09-07 Weinstein James D Protective means for a needle or similar cannula medical device
US5250035A (en) 1992-04-20 1993-10-05 Abbott Laboratories Cannula and stylet system
US5255691A (en) 1991-11-13 1993-10-26 Medtronic, Inc. Percutaneous epidural lead introducing system and method
US5271415A (en) 1992-01-28 1993-12-21 Baxter International Inc. Guidewire extension system
US5281218A (en) 1992-06-05 1994-01-25 Cardiac Pathways Corporation Catheter having needle electrode for radiofrequency ablation
US5284153A (en) 1992-04-14 1994-02-08 Brigham And Women's Hospital Method for locating a nerve and for protecting nerves from injury during surgery
US5300077A (en) 1990-07-16 1994-04-05 Arthrotek Method and instruments for ACL reconstruction
US5325868A (en) 1993-05-04 1994-07-05 Kimmelstiel Carey D Self-gripping medical wire torquer
US5341807A (en) 1992-06-30 1994-08-30 American Cardiac Ablation Co., Inc. Ablation catheter positioning system
US5351679A (en) 1992-08-17 1994-10-04 Ilya Mayzels Surgical endoscopic retractor instrument
US5353784A (en) 1993-04-02 1994-10-11 The Research Foundation Of Suny Endoscopic device and method of use
US5353802A (en) 1990-10-18 1994-10-11 Centrum For Dentalteknik Och Biomaterial Device for measurement of electrical impedance of organic and biological materials
US5353789A (en) 1991-11-21 1994-10-11 Dragerwerk Ag A flaccid mask with straps and a supporting element that force the mask into sealing engagement with the wearer's face in response to force exerted by the straps on the supporting element
US5360441A (en) 1992-10-30 1994-11-01 Medtronic, Inc. Lead with stylet capture member
US5365928A (en) 1992-11-25 1994-11-22 Medrad, Inc. Endorectal probe with planar moveable MRI coil
US5374261A (en) 1990-07-24 1994-12-20 Yoon; Inbae Multifunctional devices for use in endoscopic surgical procedures and methods-therefor
US5383879A (en) 1990-01-22 1995-01-24 Phillips; Arnold G. Bone wax applicator and method for dressing bone tissue
US5385146A (en) 1993-01-08 1995-01-31 Goldreyer; Bruce N. Orthogonal sensing for use in clinical electrophysiology
US5387218A (en) 1990-12-06 1995-02-07 University College London Surgical instrument for shaping a bone
US5396880A (en) 1992-04-08 1995-03-14 Danek Medical, Inc. Endoscope for direct visualization of the spine and epidural space
US5421348A (en) 1993-11-29 1995-06-06 Cordis Corporation Rotating guidewire extension system with mechanically locking extension wire
US5437661A (en) 1994-03-23 1995-08-01 Rieser; Bernhard Method for removal of prolapsed nucleus pulposus material on an intervertebral disc using a laser
US5439464A (en) 1993-03-09 1995-08-08 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
US5441044A (en) 1993-08-16 1995-08-15 United States Surgical Corporation Surgical retractor
US5441510A (en) 1993-09-01 1995-08-15 Technology Development Center Bi-axial cutter apparatus for catheter
US5454815A (en) 1992-04-01 1995-10-03 Imt Integral Medizintechnik Trading Ag Bone rasp made of plastics
FR2706309B1 (en) 1993-06-17 1995-10-06 Sofamor Instrument for surgical treatment of an intervertebral disc by the anterior route.
US5456254A (en) 1991-02-15 1995-10-10 Cardiac Pathways Corp Flexible strip assembly having insulating layer with conductive pads exposed through insulating layer and device utilizing the same
US5496325A (en) 1994-08-09 1996-03-05 Mclees; Donald J. Split stem surgical saw blade
US5512037A (en) 1994-05-12 1996-04-30 United States Surgical Corporation Percutaneous surgical retractor
US5515848A (en) 1991-10-22 1996-05-14 Pi Medical Corporation Implantable microelectrode
US5531749A (en) 1993-06-10 1996-07-02 Gary K. Michelson Spinal bone waxer
US5534009A (en) 1987-10-13 1996-07-09 United States Surgical Corporation Trocar assembly with rotatable tip
US5546958A (en) 1994-03-31 1996-08-20 Lake Region Manufacturing Company, Inc. Guidewire extension system with tactile connection indication
US5554110A (en) 1992-08-12 1996-09-10 Vidamed, Inc. Medical ablation apparatus
US5555892A (en) 1994-11-14 1996-09-17 Tipton; Clyde C. Biopsy shaver
US5560372A (en) 1994-02-02 1996-10-01 Cory; Philip C. Non-invasive, peripheral nerve mapping device and method of use
US5562695A (en) 1995-01-10 1996-10-08 Obenchain; Theodore G. Nerve deflecting conduit needle and method
US5571181A (en) 1992-05-11 1996-11-05 Li; Shu-Tung Soft tissue closure systems
US5582618A (en) 1993-01-12 1996-12-10 R.J. Surgical Instruments, Inc. Surgical cutting instrument
US5598848A (en) 1994-03-31 1997-02-04 Ep Technologies, Inc. Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium
US5620447A (en) 1993-01-29 1997-04-15 Smith & Nephew Dyonics Inc. Surgical instrument
US5630426A (en) 1995-03-03 1997-05-20 Neovision Corporation Apparatus and method for characterization and treatment of tumors
US5634475A (en) 1994-09-01 1997-06-03 Datascope Investment Corp. Guidewire delivery assist device and system
US5643304A (en) 1993-02-16 1997-07-01 Danek Medical, Inc. Method and apparatus for minimally invasive tissue removal
US5651373A (en) 1993-09-24 1997-07-29 Cardiometrics, Inc. Extension device, assembly thereof, heater for use therewith and method
US5656012A (en) 1994-10-06 1997-08-12 United States Surgical Corporation Surgical retractor
WO1997034536A2 (en) 1996-03-22 1997-09-25 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US5680860A (en) 1994-07-07 1997-10-28 Cardiac Pathways Corporation Mapping and/or ablation catheter with coilable distal extremity and method for using same
US5681324A (en) 1993-06-16 1997-10-28 Ethicon, Inc. Surgical tissue retrieval instrument
US5697889A (en) 1994-03-16 1997-12-16 Gus J. Slotman Surgical instruments useful for endoscopic spinal procedures
US5709697A (en) 1995-11-22 1998-01-20 United States Surgical Corporation Apparatus and method for removing tissue
US5725530A (en) 1996-06-19 1998-03-10 Popken; John A. Surgical saw and methods therefor
RU2107459C1 (en) 1994-09-29 1998-03-27 Нижегородский государственный научно-исследовательский институт травматологии и ортопедии Method and device for searching nerves and plexus nervosus
US5735792A (en) 1992-11-25 1998-04-07 Clarus Medical Systems, Inc. Surgical instrument including viewing optics and an atraumatic probe
US5755732A (en) 1994-03-16 1998-05-26 United States Surgical Corporation Surgical instruments useful for endoscopic spinal procedures
US5759159A (en) 1996-09-25 1998-06-02 Ormco Corporation Method and apparatus for apical detection with complex impedance measurement
US5762629A (en) 1991-10-30 1998-06-09 Smith & Nephew, Inc. Oval cannula assembly and method of use
US5766168A (en) 1996-01-11 1998-06-16 Northgate Technologies, Inc. Perforated resectoscope electrode assembly
US5769865A (en) 1997-02-25 1998-06-23 Surgical Insight, Inc. Instrument and method for transection of a ligament
US5775331A (en) 1995-06-07 1998-07-07 Uromed Corporation Apparatus and method for locating a nerve
US5779642A (en) 1996-01-16 1998-07-14 Nightengale; Christopher Interrogation device and method
US5788653A (en) 1996-04-03 1998-08-04 Cordis Corporation Guidewire extension with sliding release mechanism
US5792044A (en) 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5795308A (en) 1995-03-09 1998-08-18 Russin; Lincoln D. Apparatus for coaxial breast biopsy
US5800350A (en) 1993-11-01 1998-09-01 Polartechnics, Limited Apparatus for tissue type recognition
US5803904A (en) 1997-10-28 1998-09-08 Mehdizadeh; Hamid Nerve root retractor and disc space separator
US5803902A (en) 1994-10-06 1998-09-08 United States Surgical Corporation Surgical retractor
US5807263A (en) 1992-06-17 1998-09-15 Non-Invasivie Technology, Inc. Imaging of biological tissue using photon migration with high directionality techniques
US5810744A (en) 1993-05-17 1998-09-22 Boston Scientific Corporation Instrument for collecting multiple biopsy specimens
US5813405A (en) 1990-04-18 1998-09-29 Cordis Corporation Snap-in connection assembly for extension guidewire system
US5824040A (en) 1995-12-01 1998-10-20 Medtronic, Inc. Endoluminal prostheses and therapies for highly variable body lumens
US5830157A (en) 1997-05-09 1998-11-03 Merit Medical Systems, Inc. Guidewire connection guide and method of use
US5830188A (en) 1996-12-11 1998-11-03 Board Of Regents, The University Of Texas System Curved cannula for continuous spinal anesthesia
US5830151A (en) 1995-04-10 1998-11-03 Innovative Design Associates Apparatus for locating and anesthetizing peripheral nerves a method therefor
US5833692A (en) 1993-01-29 1998-11-10 Smith & Nephew, Inc. Surgical instrument
US5836948A (en) 1997-01-02 1998-11-17 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US5843110A (en) 1995-03-29 1998-12-01 Linvatec Corporation Apparatus and method for harvesting a bone-tendon-bone ligament graft
US5846244A (en) 1995-09-18 1998-12-08 Exactech, Inc. Counter-balanced oscillating surgical saw
US5846196A (en) 1995-12-13 1998-12-08 Cordis Europa N.V. Intravascular multielectrode cardiac mapping probe
US5851209A (en) 1996-01-16 1998-12-22 Hospital For Joint Diseases Bone cerclage tool
US5851191A (en) 1997-07-01 1998-12-22 Neurometrix, Inc. Apparatus and methods for assessment of neuromuscular function
US5851214A (en) 1994-10-07 1998-12-22 United States Surgical Corporation Surgical instrument useful for endoscopic procedures
US5853373A (en) 1996-08-05 1998-12-29 Becton, Dickinson And Company Bi-level charge pulse apparatus to facilitate nerve location during peripheral nerve block procedures
US5865844A (en) 1989-08-18 1999-02-02 Endovascular Instruments, Inc. Anti-stenotic method and product for occluded and partially occluded arteries
US5868767A (en) 1994-12-23 1999-02-09 Devices For Vascular Intervention Universal catheter with interchangeable work element
US5879353A (en) 1995-01-17 1999-03-09 Gore Enterprise Holdings, Inc. Guided bone rasp
US5895417A (en) 1996-03-06 1999-04-20 Cardiac Pathways Corporation Deflectable loop design for a linear lesion ablation apparatus
WO1999018866A1 (en) 1997-10-14 1999-04-22 Parallax Medical, Inc. Precision instruments for use in vertebroplasty
US5897583A (en) 1994-07-13 1999-04-27 Fraunhofer Gesellschaft Zur Forderung Der Angewandten Forschung E.V. Flexible artificial nerve plates
US5899909A (en) 1994-08-30 1999-05-04 Medscand Medical Ab Surgical instrument for treating female urinary incontinence
WO1999021500A1 (en) 1997-10-27 1999-05-06 Saint Francis Medical Technologies, Llc Spine distraction implant
US5904657A (en) 1997-02-26 1999-05-18 Unsworth; John D. System for guiding devices in body lumens
US5916173A (en) 1997-02-26 1999-06-29 Kirsner; Vaclav Methods and apparatus for monitoring fertility status in the mammalian vagina
US5918604A (en) 1997-02-12 1999-07-06 Arthrex, Inc. Method of loading tendons into the knee
US5919190A (en) 1996-12-20 1999-07-06 Vandusseldorp; Gregg A. Cutting loop for an electrocautery probe
US5928158A (en) 1997-03-25 1999-07-27 Aristides; Arellano Medical instrument with nerve sensor
US5941822A (en) 1997-03-17 1999-08-24 Polartechnics Limited Apparatus for tissue type recognition within a body canal
US5961522A (en) 1997-11-10 1999-10-05 Mehdizadeh; Hamid M. Laminectomy chisel and guide apparatus
JP2960140B2 (en) 1990-10-02 1999-10-06 ユニチカ株式会社 Surgical suture assembly
US5972013A (en) 1997-09-19 1999-10-26 Comedicus Incorporated Direct pericardial access device with deflecting mechanism and method
US5976110A (en) 1998-01-14 1999-11-02 Duke University Catheter system for administration of continuous peripheral nerve anesthetic
US5976146A (en) 1997-07-11 1999-11-02 Olympus Optical Co., Ltd. Surgical operation system and method of securing working space for surgical operation in body
US6002964A (en) 1998-07-15 1999-12-14 Feler; Claudio A. Epidural nerve root stimulation
US6004326A (en) 1997-09-10 1999-12-21 United States Surgical Method and instrumentation for implant insertion
US6010493A (en) 1992-07-06 2000-01-04 Catheter Imaging Systems Method of epidural surgery
US6015406A (en) 1996-01-09 2000-01-18 Gyrus Medical Limited Electrosurgical instrument
US6022362A (en) 1998-09-03 2000-02-08 Rubicor Medical, Inc. Excisional biopsy devices and methods
US6030383A (en) 1996-05-21 2000-02-29 Benderev; Theodore V. Electrosurgical instrument and method of use
US6030401A (en) 1998-10-07 2000-02-29 Nuvasive, Inc. Vertebral enplate decorticator and osteophyte resector
US6038480A (en) 1996-04-04 2000-03-14 Medtronic, Inc. Living tissue stimulation and recording techniques with local control of active sites
US6048345A (en) 1999-04-08 2000-04-11 Joseph J. Berke Motorized reciprocating surgical file apparatus and method
US6068642A (en) 1996-03-01 2000-05-30 Orthopaedic Innovations, Inc. Flexible cutting tool and methods for its use
US6073051A (en) 1996-08-13 2000-06-06 Oratec Interventions, Inc. Apparatus for treating intervertebal discs with electromagnetic energy
US6099514A (en) 1996-08-13 2000-08-08 Oratec Interventions, Inc. Method and apparatus for delivering or removing material from the interior of an intervertebral disc
US6102930A (en) 1997-05-16 2000-08-15 Simmons, Jr.; Edward D. Volumetric measurement device and method in lateral recess and foraminal spinal stenosis
US6106558A (en) 1997-09-15 2000-08-22 Applied Medical Research, Inc. Neuro decompression device
US6113534A (en) 1998-03-19 2000-09-05 Koros; Tibor B. Adjustable heart surface stabilizer
US6132387A (en) 1997-07-01 2000-10-17 Neurometrix, Inc. Neuromuscular electrode
USD432384S (en) 2000-01-21 2000-10-24 Sandpaper tool
US6136014A (en) 1998-09-01 2000-10-24 Vivant Medical, Inc. Percutaneous tissue removal device
US6142993A (en) 1998-02-27 2000-11-07 Ep Technologies, Inc. Collapsible spline structure using a balloon as an expanding actuator
US6142994A (en) 1994-10-07 2000-11-07 Ep Technologies, Inc. Surgical method and apparatus for positioning a diagnostic a therapeutic element within the body
US6146380A (en) 1998-01-09 2000-11-14 Radionics, Inc. Bent tip electrical surgical probe
WO2000067651A1 (en) 1999-05-10 2000-11-16 Highgate Orthopedics, Inc. Systems and methods for spinal fixation
US6152894A (en) 1997-10-27 2000-11-28 Kubler; Harald Surgical cutting instrument
US6169916B1 (en) 1996-08-08 2001-01-02 Medtronic Inc. Electrophysiology catheter with multifunctional wire and method for making
WO2001008571A1 (en) 1999-08-01 2001-02-08 Disc-O-Tech Medical Technologies Ltd. Method and apparatus for spinal procedures
US6205360B1 (en) 1995-09-07 2001-03-20 Cochlear Limited Apparatus and method for automatically determining stimulation parameters
US6214016B1 (en) 1999-04-29 2001-04-10 Medtronic, Inc. Medical instrument positioning device internal to a catheter or lead and method of use
US6214001B1 (en) 1997-09-19 2001-04-10 Oratec Interventions, Inc. Electrocauterizing tool for orthopedic shave devices
US6236892B1 (en) 1999-10-07 2001-05-22 Claudio A. Feler Spinal cord stimulation lead
US6256540B1 (en) 1994-01-28 2001-07-03 Ep Technologies Systems and methods for examining the electrical characteristic of cardiac tissue
US6259945B1 (en) 1999-04-30 2001-07-10 Uromed Corporation Method and device for locating a nerve
US6261582B1 (en) 1996-10-15 2001-07-17 C. R. Bard, Inc. Surgical method and composition therefor
US6266551B1 (en) 1996-02-15 2001-07-24 Biosense, Inc. Catheter calibration and usage monitoring system
US6266558B1 (en) 1998-12-01 2001-07-24 Neurometrix, Inc. Apparatus and method for nerve conduction measurements with automatic setting of stimulus intensity
US6267760B1 (en) 1998-05-05 2001-07-31 Scimed Life Systems, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and forming an incision in tissue with minimal blood loss
US20010014806A1 (en) 1999-05-03 2001-08-16 Ellman Alan G. Electrosurgical handpiece for treating tissue
US6277094B1 (en) 1999-04-28 2001-08-21 Medtronic, Inc. Apparatus and method for dilating ligaments and tissue by the alternating insertion of expandable tubes
US6280447B1 (en) 1998-12-23 2001-08-28 Nuvasive, Inc. Bony tissue resector
WO2001062168A2 (en) 2000-02-25 2001-08-30 Oratec Interventions, Inc. Apparatus and method for accessing and performing a function within an intervertebral disc
US6292702B1 (en) 1998-04-30 2001-09-18 Medtronic, Inc. Apparatus and method for expanding a stimulation lead body in situ
US20010025192A1 (en) 1999-04-29 2001-09-27 Medtronic, Inc. Single and multi-polar implantable lead for sacral nerve electrical stimulation
US6298256B1 (en) 1999-09-10 2001-10-02 Frank-Egbert Meyer Device and method for the location and catheterization of the surroundings of a nerve
US6312392B1 (en) 2000-04-06 2001-11-06 Garrett D. Herzon Bipolar handheld nerve locator and evaluator
US20010039419A1 (en) 2000-04-27 2001-11-08 Medtronic, Inc. Vibration sensitive ablation device and method
US6324418B1 (en) 1997-09-29 2001-11-27 Boston Scientific Corporation Portable tissue spectroscopy apparatus and method
US6324432B1 (en) 1999-11-01 2001-11-27 Compex Sa Electrical neuromuscular stimulator for measuring muscle responses to electrical stimulation pulses
US20010049527A1 (en) 2000-02-16 2001-12-06 Cragg Andrew H. Methods and apparatus for performing therapeutic procedures in the spine
US20010053885A1 (en) 1998-04-30 2001-12-20 Frans Gielen Techniques for positioning therapy delivery elements within a spinal cord or a brain
US6334068B1 (en) 1999-09-14 2001-12-25 Medtronic Xomed, Inc. Intraoperative neuroelectrophysiological monitor
US6343226B1 (en) 1999-06-25 2002-01-29 Neurokinetic Aps Multifunction electrode for neural tissue stimulation
WO2002007901A1 (en) 2000-07-25 2002-01-31 Alan Bertram Kingsbury Flexible file and method for making it
US20020016555A1 (en) 1994-03-24 2002-02-07 Ritchart Mark A. Methods and devices for automated biopsy and collection of soft tissue
US20020019637A1 (en) 1999-10-21 2002-02-14 George Frey Devices and techniques for a posterior lateral disc space approach
US20020022788A1 (en) 1999-08-19 2002-02-21 Tim Corvi Apparatus and methods for material capture and removal
US20020022873A1 (en) 2000-08-10 2002-02-21 Erickson John H. Stimulation/sensing lead adapted for percutaneous insertion
US20020029060A1 (en) 1998-07-29 2002-03-07 Michael Hogendijk Surgical cutting instrument and method of use
US6358254B1 (en) 2000-09-11 2002-03-19 D. Greg Anderson Method and implant for expanding a spinal canal
US6360750B1 (en) 1999-04-29 2002-03-26 Medtronic, Inc. Minimally invasive surgical techniques for implanting devices that deliver stimulant to the nervous system
US6364886B1 (en) 1996-06-04 2002-04-02 Joseph H. Sklar Apparatus and method for reconstructing ligaments
US6368324B1 (en) 1999-09-24 2002-04-09 Medtronic Xomed, Inc. Powered surgical handpiece assemblies and handpiece adapter assemblies
US6370411B1 (en) 1998-02-10 2002-04-09 Biosense, Inc. Catheter calibration
WO2002034120A2 (en) 2000-10-27 2002-05-02 Blackstone Medical, Inc. Facet fixation devices
US6383509B1 (en) 2000-06-02 2002-05-07 Allergan Sales, Inc. Biodegradable neurotoxin implant
US6391028B1 (en) 1997-02-12 2002-05-21 Oratec Interventions, Inc. Probe with distally orientated concave curve for arthroscopic surgery
US6390906B1 (en) 1998-07-06 2002-05-21 Saint-Gobain Abrasives Technology Company Flexible abrasive belts
US6416505B1 (en) 1998-05-05 2002-07-09 Scimed Life Systems, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and pressure application probe for use with same
US6423071B1 (en) 2000-07-25 2002-07-23 Kevin Jon Lawson Surgical tool and method for passing pilot-line sutures through spinal vertebrae
US6423080B1 (en) 1997-02-13 2002-07-23 Scimed Life Systems, Inc. Percutaneous and hiatal devices and methods for use in minimally invasive pelvic surgery
US6425887B1 (en) 1998-12-09 2002-07-30 Cook Incorporated Multi-directional needle medical device
US20020106681A1 (en) 2000-11-24 2002-08-08 Alvin Wexler High definition electrical impedance tomography methods for the detection and diagnosis of early stages of breast cancer
US6436101B1 (en) 1999-10-13 2002-08-20 James S. Hamada Rasp for use in spine surgery
US6442848B1 (en) 1999-03-22 2002-09-03 Ethan Dean Coping saw
US6446621B1 (en) 1998-01-21 2002-09-10 Hagby Asahi Ab Saw wire
US6451335B1 (en) 1998-07-02 2002-09-17 Euro-Celtique S.A. Formulations and methods for providing prolonged local anesthesia
US6454767B2 (en) 1992-11-12 2002-09-24 Neville Alleyne Protection device
US20020138091A1 (en) 2001-03-23 2002-09-26 Devonrex, Inc. Micro-invasive nucleotomy device and method
WO2002076311A2 (en) 2001-03-23 2002-10-03 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6466817B1 (en) 1999-11-24 2002-10-15 Nuvasive, Inc. Nerve proximity and status detection system and method
US6468289B1 (en) 1990-06-28 2002-10-22 Peter M. Bonutti Apparatus and method for tissue removal
US20020165590A1 (en) 2001-01-16 2002-11-07 Crowe Louis Michael Apparatus for stimulating a muscle of a subject
US6478805B1 (en) 1999-04-16 2002-11-12 Nuvasive, Inc. System for removing cut tissue from the inner bore of a surgical instrument
US6487439B1 (en) 1997-03-17 2002-11-26 Victor N. Skladnev Glove-mounted hybrid probe for tissue type recognition
US6488636B2 (en) 1997-09-19 2002-12-03 United States Surgical Corporation Biopsy apparatus
US20020183647A1 (en) 1997-07-01 2002-12-05 Gozani Shai N. Apparatus and method for performing nerve conduction studies with localization of evoked responses
US6491646B1 (en) 1993-03-11 2002-12-10 Lake Region Manufacturing, Inc. Guidewire extension system
US6500189B1 (en) 1999-04-29 2002-12-31 Karl Storz Gmbh & Co. Kg Medical instrument for dissecting tissue
US6500128B2 (en) 2000-06-08 2002-12-31 Nuvasive, Inc. Nerve movement and status detection system and method
US6512958B1 (en) 2001-04-26 2003-01-28 Medtronic, Inc. Percutaneous medical probe and flexible guide wire
US20030023190A1 (en) 2001-06-20 2003-01-30 Micro Vention, Inc. Medical devices having full or partial polymer coatings and their methods of manufacture
US6516223B2 (en) 1997-08-01 2003-02-04 Genetronics, Inc. Apparatus for electroporation mediated delivery for drugs and genes
US6527786B1 (en) 1998-04-09 2003-03-04 Origin Medsystems, Inc. System and method of use for ligating and cutting tissue
US20030045937A1 (en) * 2001-09-06 2003-03-06 Integrated Vascular Systems, Inc. Apparatus and methods for treating spinal discs
US6533749B1 (en) 1999-09-24 2003-03-18 Medtronic Xomed, Inc. Angled rotary tissue cutting instrument with flexible inner member
US6540742B1 (en) 1997-07-24 2003-04-01 Stuart Thomas Intraoperative endocardial and epicardial ablation probe
US6540761B2 (en) 1995-01-23 2003-04-01 Russell A. Houser Tissue cutting/tissue removing device with vacuum feature
WO2003026482A2 (en) 2001-09-25 2003-04-03 Nuvasive, Inc. System and methods for performing surgical procedures and assessments
US6546270B1 (en) 2000-07-07 2003-04-08 Biosense, Inc. Multi-electrode catheter, system and method
US20030074037A1 (en) 2001-10-17 2003-04-17 Rehabilicare, Inc. Electrical nerve stimulation device
EP1304080A2 (en) 2001-10-19 2003-04-23 Mani, Inc. Surgical ribbon file
US6558353B2 (en) 2001-01-25 2003-05-06 Walter A. Zohmann Spinal needle
US6564088B1 (en) 2000-01-21 2003-05-13 University Of Massachusetts Probe for localized tissue spectroscopy
US6564079B1 (en) 2000-07-27 2003-05-13 Ckm Diagnostics, Inc. Electrode array and skin attachment system for noninvasive nerve location and imaging device
US6564078B1 (en) 1998-12-23 2003-05-13 Nuvasive, Inc. Nerve surveillance cannula systems
US6562033B2 (en) 2001-04-09 2003-05-13 Baylis Medical Co. Intradiscal lesioning apparatus
US6569160B1 (en) 2000-07-07 2003-05-27 Biosense, Inc. System and method for detecting electrode-tissue contact
US20030105503A1 (en) 2001-06-08 2003-06-05 Nuvasive, Inc. Relative nerve movement and status detection system and method
US6575979B1 (en) 2000-02-16 2003-06-10 Axiamed, Inc. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US20030109871A1 (en) 2000-07-25 2003-06-12 Johnson Theodore C. Apparatus for detecting and treating tumors using locaIized impedance measurement
US6579291B1 (en) 2000-10-10 2003-06-17 Spinalabs, Llc Devices and methods for the treatment of spinal disorders
US20030113906A1 (en) 2001-12-14 2003-06-19 Sangha Jangbir S. Method and apparatus for DNA collection
US6584345B2 (en) 2001-03-13 2003-06-24 Biosense, Inc. Apparatus and method for measuring a plurality of electrical signals from the body of a patient
US20030130738A1 (en) 2001-11-08 2003-07-10 Arthrocare Corporation System and method for repairing a damaged intervertebral disc
US20030130655A1 (en) 1995-06-07 2003-07-10 Arthrocare Corporation Electrosurgical systems and methods for removing and modifying tissue
US6595932B2 (en) 1998-12-28 2003-07-22 Micrus Corporation Composite guidewire
US6606523B1 (en) 1999-04-14 2003-08-12 Transneuronix Inc. Gastric stimulator apparatus and method for installing
WO2003066147A1 (en) 2002-02-04 2003-08-14 Kaplan Aaron V Methods and apparatus for pericardial access
EP1340467A2 (en) 1996-05-09 2003-09-03 Olympus Optical Co., Ltd. A cavity retaining tool for general surgery
US20030167021A1 (en) 2002-03-04 2003-09-04 Shimm Peter B. Apparatus for locating and anesthetizing nerve groups
US6620129B2 (en) 2001-07-09 2003-09-16 Eric C. Stecker Enlargeable multifunctional devices
US6624510B1 (en) 2000-09-28 2003-09-23 University Of Iowa Research Foundation Electrode array having a thin, flexible substrate
US6622731B2 (en) 2001-01-11 2003-09-23 Rita Medical Systems, Inc. Bone-treatment instrument and method
US6626916B1 (en) 1998-12-31 2003-09-30 Teresa T. Yeung Tissue fastening devices and methods for sustained holding strength
US20030187368A1 (en) 2000-06-12 2003-10-02 Masataka Sata Medical guide wire doubling as a catheter
US20030188749A1 (en) 2002-04-05 2003-10-09 Nichols Travis R. Systems and methods for endotracheal intubation
US6632184B1 (en) 2000-02-11 2003-10-14 Regents Of The University Of Minnesota Method and device for deflecting a probe
US20030208206A1 (en) 2002-05-01 2003-11-06 Norm Gitis Multiportal device and method for percutaneous surgery
US20030212400A1 (en) 2002-03-12 2003-11-13 Aesculap Ag & Co. Kg Methods for treating spinal stenosis by pedicle distraction
US6648883B2 (en) 2001-04-26 2003-11-18 Medtronic, Inc. Ablation system and method of use
USRE38335E1 (en) 1994-05-24 2003-11-25 Endius Incorporated Surgical instrument
US20030225415A1 (en) 2002-01-18 2003-12-04 Alain Richard Method and apparatus for reconstructing bone surfaces during surgery
US6666874B2 (en) 1998-04-10 2003-12-23 Endicor Medical, Inc. Rotational atherectomy system with serrated cutting tip
US6673063B2 (en) 2000-10-06 2004-01-06 Expanding Concepts, Llc. Epidural thermal posterior annuloplasty
US6673068B1 (en) 2000-04-12 2004-01-06 Afx, Inc. Electrode arrangement for use in a medical instrument
WO2004002331A1 (en) 2002-06-29 2004-01-08 Hee-Young Lee Facial bone contouring device using hollowed rasp provided with non-plugging holes formed through cutting plane
US20040006379A1 (en) 2000-10-06 2004-01-08 Expanding Concepts, L.L.C. Epidural thermal posterior annuloplasty
US20040006391A1 (en) 1999-10-22 2004-01-08 Archus Orthopedics Inc. Facet arthroplasty devices and methods
US6678552B2 (en) 1994-10-24 2004-01-13 Transscan Medical Ltd. Tissue characterization based on impedance images and on impedance measurements
US6682535B2 (en) 1999-06-16 2004-01-27 Thomas Hoogland Apparatus for decompressing herniated intervertebral discs
US6682536B2 (en) 2000-03-22 2004-01-27 Advanced Stent Technologies, Inc. Guidewire introducer sheath
US20040019359A1 (en) 2002-07-24 2004-01-29 Worley Seth J. Telescopic introducer with a compound curvature for inducing alignment and method of using the same
US20040024399A1 (en) 1995-04-13 2004-02-05 Arthrocare Corporation Method for repairing damaged intervertebral discs
US20040030330A1 (en) 2002-04-18 2004-02-12 Brassell James L. Electrosurgery systems
US6699246B2 (en) 1997-01-02 2004-03-02 St. Francis Medical Technologies, Inc. Spine distraction implant
US20040049208A1 (en) 2002-04-03 2004-03-11 Thomas Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
US20040054368A1 (en) 1998-07-13 2004-03-18 Novacept Apparatuses and methods for interstitial tissue removal
US20040059247A1 (en) 2002-09-04 2004-03-25 Urmey William F. Positioning system for a nerve stimulator needle
US20040064058A1 (en) 2001-10-24 2004-04-01 Mckay William F. Methods and instruments for treating pseudoarthrosis
WO2004028351A2 (en) 2002-09-27 2004-04-08 Surgifile, Inc. Shielded reciprocating surgical file
US20040067000A1 (en) 2002-10-07 2004-04-08 Bates Kenneth N. Systems and methods for minimally-invasive optical-acoustic imaging
US6723049B2 (en) 2001-06-15 2004-04-20 Polartechnics Limited Apparatus for tissue type recognition using multiple measurement techniques
US6726531B1 (en) 1999-03-26 2004-04-27 Stephen K. Harrel Abrasive tool having safe and active areas
US6726685B2 (en) 2001-06-06 2004-04-27 Oratec Interventions, Inc. Intervertebral disc device employing looped probe
US6733496B2 (en) 2001-06-06 2004-05-11 Oratec Interventions, Inc. Intervertebral disc device employing flexible probe
US6736835B2 (en) 2002-03-21 2004-05-18 Depuy Acromed, Inc. Early intervention spinal treatment methods and devices for use therein
US20040097927A1 (en) 2001-02-13 2004-05-20 Yeung Jeffrey E. Intervertebral disc repair
US20040098074A1 (en) 2002-11-20 2004-05-20 Erickson John H. Apparatus for directionally stimulating nerve tissue
WO2004043272A1 (en) 2002-11-14 2004-05-27 Sydney West Area Health Service An intramural needle-tipped surgical device
US20040102721A1 (en) 2002-11-22 2004-05-27 Mckinley Laurence M. System, method and apparatus for locating, measuring and evaluating the enlargement of a foramen
US20040106940A1 (en) 2002-11-08 2004-06-03 Shaolian Samuel M. Transpedicular intervertebral disk access methods and devices
US6746451B2 (en) 2001-06-01 2004-06-08 Lance M. Middleton Tissue cavitation device and method
US20040116977A1 (en) 2002-12-13 2004-06-17 Finch Philip M. System and method for electrical stimulation of the intervertebral disc
US20040122433A1 (en) 2001-02-06 2004-06-24 Thierry Loubens Endoscopic rongeur-type surgical instrument
US20040122482A1 (en) 2002-12-20 2004-06-24 James Tung Nerve proximity method and device
US20040127893A1 (en) 2002-12-13 2004-07-01 Arthrocare Corporation Methods for visualizing and treating intervertebral discs
US20040127963A1 (en) 1999-01-25 2004-07-01 Uchida Andy H. Intervertebral decompression
US6760616B2 (en) 2000-05-18 2004-07-06 Nu Vasive, Inc. Tissue discrimination and applications in medical procedures
US20040133208A1 (en) 2000-09-01 2004-07-08 Synthes (Usa) Tools and methods for creating cavities in bone
US20040143280A1 (en) 2003-01-17 2004-07-22 Loubert Suddaby Flexible wire transection the transverse carpal ligament
US20040143165A1 (en) 2000-01-21 2004-07-22 Neville Alleyne Intervertebral disc repair methods and apparatus
US6772012B2 (en) 1995-06-07 2004-08-03 Arthrocare Corporation Methods for electrosurgical treatment of spinal tissue
US6776765B2 (en) 2001-08-21 2004-08-17 Synovis Life Technologies, Inc. Steerable stylet
US20040162609A1 (en) 1999-12-23 2004-08-19 Hossainy Syed F.A. Coating for implantable devices and a method of forming the same
US20040167553A1 (en) 2000-12-20 2004-08-26 Fox Hollow Technologies, Inc. Methods and devices for cutting tissue
US20040167444A1 (en) 1998-02-13 2004-08-26 Ventrica, Inc., Corporation Of Delaware Placing a guide member into a heart chamber through a coronary vessel and delivering devices for placing the coronary vessel in communication with the heart chamber
US6788966B2 (en) 2001-10-22 2004-09-07 Transscan Medical Ltd. Diagnosis probe
US6790210B1 (en) 2000-02-16 2004-09-14 Trans1, Inc. Methods and apparatus for forming curved axial bores through spinal vertebrae
US20040181150A1 (en) 1999-09-01 2004-09-16 Bacchus Vascular, Inc. Methods and apparatus for accessing and treating body lumens
WO2004078066A2 (en) 2003-03-03 2004-09-16 Sinus Rhythm Technologies, Inc. Primary examiner
WO2004080316A1 (en) 2003-03-13 2004-09-23 Sdgi Holdings, Inc. Vertebral endplate preparation tool kit
US20040199159A1 (en) 2001-09-12 2004-10-07 Manoa Medical, Inc., A Delaware Corporation Devices and methods for tissue severing and removal
US20040199166A1 (en) 2003-03-18 2004-10-07 Reinhold Schmieding ACL reconstruction technique using retrodrill
US20040199084A1 (en) 1999-11-24 2004-10-07 Nuvasive, Inc. Electromyography system
US6807444B2 (en) 2001-11-05 2004-10-19 Hosheng Tu Apparatus and methods for monitoring tissue impedance
US6805697B1 (en) 1999-05-07 2004-10-19 University Of Virginia Patent Foundation Method and system for fusing a spinal region
US6805695B2 (en) 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US20040225233A1 (en) * 2003-05-09 2004-11-11 Frankowski Brian J. Magnetic guidewires
WO2004096080A2 (en) 2003-04-25 2004-11-11 Vertelink Corporation System and method for minimally invasive posterior fixation
US6832111B2 (en) 2001-07-06 2004-12-14 Hosheng Tu Device for tumor diagnosis and methods thereof
US6830561B2 (en) 2002-05-08 2004-12-14 Scimed Life Systems, Inc. Catheter with protective sleeve
US6830570B1 (en) 1999-10-21 2004-12-14 Sdgi Holdings, Inc. Devices and techniques for a posterior lateral disc space approach
US20040260358A1 (en) 2003-06-17 2004-12-23 Robin Vaughan Triggered electromyographic test device and methods of use thereof
US6845264B1 (en) 1998-10-08 2005-01-18 Victor Skladnev Apparatus for recognizing tissue types
US6847849B2 (en) 2000-11-15 2005-01-25 Medtronic, Inc. Minimally invasive apparatus for implanting a sacral stimulation lead
WO2005009300A1 (en) 2003-07-24 2005-02-03 Byung-Kwan Choi Prosthesis for vertebra
US20050027199A1 (en) 2001-04-11 2005-02-03 Clarke Dana S. Tissue structure identification in advance of instrument
US6851430B2 (en) 2000-05-01 2005-02-08 Paul M. Tsou Method and apparatus for endoscopic spinal surgery
US20050033393A1 (en) 2003-08-08 2005-02-10 Advanced Neuromodulation Systems, Inc. Apparatus and method for implanting an electrical stimulation system and a paddle style electrical stimulation lead
US6865409B2 (en) 2001-11-07 2005-03-08 Kinesense, Inc. Surface electromyographic electrode assembly
US20050060006A1 (en) 2000-03-20 2005-03-17 Pflueger D. Russell Epidural nerve root access catheter and treatment methods
US6875221B2 (en) 2001-12-14 2005-04-05 Bausch & Lomb Incorporated Turbine driven vitrectomy cutter
US6882879B2 (en) 2000-07-19 2005-04-19 Innovamedica S.A. De C.V. Impedance spectroscopy system and catheter for ischemic mucosal damage monitoring in hollow viscous organs
US6884220B2 (en) 2001-06-29 2005-04-26 The Trustees Of Columbia University In The City Of New York Optical transesophageal echocardiography probe
US6890353B2 (en) 2001-03-23 2005-05-10 Viacor, Inc. Method and apparatus for reducing mitral regurgitation
EP1315463B1 (en) 2000-09-07 2005-05-11 Sherwood Services AG Apparatus for the treatment of the intervertebral disc
US6899716B2 (en) 2000-02-16 2005-05-31 Trans1, Inc. Method and apparatus for spinal augmentation
US6907884B2 (en) 2002-09-30 2005-06-21 Depay Acromed, Inc. Method of straddling an intraosseous nerve
WO2005057467A2 (en) 2003-12-02 2005-06-23 Subqiview Inc. Tissue characterization using an eddy-current probe
US6911003B2 (en) 2002-03-07 2005-06-28 Ams Research Corporation Transobturator surgical articles and methods
US6911016B2 (en) 2001-08-06 2005-06-28 Scimed Life Systems, Inc. Guidewire extension system
US20050149035A1 (en) 2003-10-17 2005-07-07 Nuvasive, Inc. Surgical access system and related methods
US20050149154A1 (en) 2003-12-29 2005-07-07 Biocontrol Medical Bcm Ltd. Nerve-branch-specific action-potential activation,inhibition, and monitoring
US20050149034A1 (en) 2003-10-23 2005-07-07 Assell Robert L. Method and apparatus for manipulating material in the spine
US6916328B2 (en) 2001-11-15 2005-07-12 Expanding Concepts, L.L.C Percutaneous cellulite removal system
US6923813B2 (en) 2003-09-03 2005-08-02 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US20050171587A1 (en) 2003-11-25 2005-08-04 Advanced Neuromodulation Systems, Inc. Directional stimulation lead and orientation system
US6929647B2 (en) 2001-02-21 2005-08-16 Howmedica Osteonics Corp. Instrumentation and method for implant insertion
US20050182454A1 (en) 2001-07-11 2005-08-18 Nuvasive, Inc. System and methods for determining nerve proximity, direction, and pathology during surgery
US20050187537A1 (en) 2004-02-19 2005-08-25 Loeb Marvin P. Angular deflection apparatus for use in confined spaces and method of use
WO2005077282A1 (en) 2004-02-11 2005-08-25 Spinevision Exploration device for monitoring the penetration of an instrument into an anatomical structure
US20050197661A1 (en) 2004-03-03 2005-09-08 Scimed Life Systems, Inc. Tissue removal probe with sliding burr in cutting window
US20050203599A1 (en) 2004-03-12 2005-09-15 Scimed Life Systems, Inc. Modular stimulation lead network
US20050209622A1 (en) 2004-03-03 2005-09-22 Scimed Life Systems, Inc. Tissue removal probe with irrigation and aspiration ports
US20050209610A1 (en) 2004-03-03 2005-09-22 Scimed Life Systems, Inc. Radially adjustable tissue removal device
US20050209617A1 (en) 2004-03-05 2005-09-22 Paul Koven Valvulotome
US6949104B2 (en) 2002-05-31 2005-09-27 Jack Griffis Guide wire steering handle
WO2005089433A2 (en) 2004-03-18 2005-09-29 Onset Medical, Inc. Expandable medical access device
US20050216023A1 (en) 2004-03-29 2005-09-29 Luke Aram Method and apparatus for arthroscopic bone preparation
US20050222598A1 (en) 2004-04-05 2005-10-06 Manoa Medical, Inc., A Delaware Corporation Tissue cutting device
US20050234425A1 (en) 2004-04-16 2005-10-20 Innospine, Inc. Spinal diagnostic methods and apparatus
US20050256423A1 (en) 2002-07-01 2005-11-17 Vaclav Kirsner Vaginal probe
US20050261692A1 (en) 2004-05-21 2005-11-24 Scimed Life Systems, Inc. Articulating tissue removal probe and methods of using the same
US6971986B2 (en) 2001-01-23 2005-12-06 American Medical Systems, Inc. Sling delivery system and method of use
US6972199B2 (en) 2000-07-25 2005-12-06 Verimetra, Inc. Method of making a cutting instrument having integrated sensors
US6973342B1 (en) 2000-03-02 2005-12-06 Advanced Neuromodulation Systems, Inc. Flexible bio-probe assembly
US20050277942A1 (en) 2004-05-27 2005-12-15 Kullas Karen E Method and apparatus for delivering a prosthetic fabric into a patient
US20050283148A1 (en) 2004-06-17 2005-12-22 Janssen William M Ablation apparatus and system to limit nerve conduction
US20050283204A1 (en) 2004-01-30 2005-12-22 Felix Buhlmann Automated adaptive muscle stimulation method and apparatus
EP1611851A1 (en) 2004-06-30 2006-01-04 Thompson Surgical Instruments, Inc. Elongateable surgical port and dilator
US20060004369A1 (en) 2004-06-17 2006-01-05 Scimed Life Systems, Inc. Slidable sheaths for tissue removal devices
US6991643B2 (en) 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US20060025703A1 (en) 2003-08-05 2006-02-02 Nuvasive, Inc. System and methods for performing dynamic pedicle integrity assessments
US20060025702A1 (en) 2004-07-29 2006-02-02 Medtronic Xomed, Inc. Stimulator handpiece for an evoked potential monitoring system
US20060025797A1 (en) 2004-07-15 2006-02-02 James Lock Cannula for in utero surgery
US6994693B2 (en) 2001-07-17 2006-02-07 Yale University Tunneler-needle combination for tunneled catheter placement
WO2006015302A1 (en) 2004-07-29 2006-02-09 X-Sten, Corp. Spinal ligament modification devices
US20060030854A1 (en) 2004-02-02 2006-02-09 Haines Timothy G Methods and apparatus for wireplasty bone resection
US6999820B2 (en) 2003-05-29 2006-02-14 Advanced Neuromodulation Systems, Inc. Winged electrode body for spinal cord stimulation
US6997934B2 (en) 1999-08-19 2006-02-14 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
WO2006017507A2 (en) 2004-08-03 2006-02-16 Triage Medical Telescopic percutaneous tissue dilation systems and related methods
US7001333B2 (en) 2000-12-20 2006-02-21 Hamel Ross J Surgical retractor system
US7010352B2 (en) 2002-12-11 2006-03-07 The Mcw Research Foundation, Inc. Transcutaneous electrical nerve locator
US7008431B2 (en) 2001-10-30 2006-03-07 Depuy Spine, Inc. Configured and sized cannula
US7011635B1 (en) 1999-12-10 2006-03-14 Sedat Manual control device for a surgical guide
US7011663B2 (en) 1989-08-28 2006-03-14 Gary Karlin Michelson Surgical rongeur having a removable storage member
US20060064101A1 (en) 2004-02-12 2006-03-23 Arthrocare Corporation Bone access system
WO2006039279A2 (en) 2004-09-29 2006-04-13 Synthes (U.S.A) Less invasive surgical system and methods
US20060085048A1 (en) 2004-10-20 2006-04-20 Nervonix, Inc. Algorithms for an active electrode, bioimpedance-based tissue discrimination system
US20060085049A1 (en) 2004-10-20 2006-04-20 Nervonix, Inc. Active electrode, bio-impedance based, tissue discrimination system and methods of use
WO2006042206A2 (en) 2004-10-06 2006-04-20 Nuvasive, Inc. Systems and methods for direct restoration of foraminal volume
US7033373B2 (en) 2000-11-03 2006-04-25 Satiety, Inc. Method and device for use in minimally invasive placement of space-occupying intragastric devices
US20060089650A1 (en) 2003-04-11 2006-04-27 Martin Nolde Rasp attachment for a motor-driven surgical hand-held device
US20060089640A1 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue modification
US20060089633A1 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue access
US20060089688A1 (en) 2004-10-25 2006-04-27 Dorin Panescu Method and apparatus to reduce wrinkles through application of radio frequency energy to nerves
US20060095026A1 (en) 1995-06-07 2006-05-04 Arthrocare Corporation Methods for electrosurgical treatment of spinal tissue
WO2006047598A1 (en) 2002-09-27 2006-05-04 Surgifile, Inc. Surgical file system
US7048682B2 (en) 2001-01-23 2006-05-23 American Medical Systems, Inc. Surgical articles and methods
WO2006058195A2 (en) 2004-11-23 2006-06-01 Pneumrx, Inc. Steerable device for accessing a target site and methods
US20060122654A1 (en) 2001-12-04 2006-06-08 Kerry Bradley Apparatus and method for determining the relative position and orientation of neurostimulation leads
US20060122458A1 (en) 2004-10-15 2006-06-08 Baxano, Inc. Devices and methods for tissue access
US20060122620A1 (en) 2004-10-20 2006-06-08 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for stabilizing the motion or adjusting the position of the spine
WO2006062555A2 (en) 2004-12-06 2006-06-15 Mckinley Laurence M Improved surgical rongeur
US7063682B1 (en) 1996-12-19 2006-06-20 Ep Technologies, Inc. Catheter distal assembly with pull wires
US20060142753A1 (en) 2001-04-26 2006-06-29 Medtronic, Inc. Ablation system and method of use
US7070556B2 (en) 2002-03-07 2006-07-04 Ams Research Corporation Transobturator surgical articles and methods
US7070596B1 (en) 2000-08-09 2006-07-04 Arthrocare Corporation Electrosurgical apparatus having a curved distal section
US20060149278A1 (en) 2004-11-24 2006-07-06 Abdou Amy M Devices and methods for inter-vertebral orthopedic device placement
US7079883B2 (en) 1998-12-23 2006-07-18 Nuvaslve, Inc. Nerve surveillance cannulae systems
US7081122B1 (en) 1999-10-19 2006-07-25 Kyphon Inc. Hand-held instruments that access interior body regions
US20060173374A1 (en) 2005-01-31 2006-08-03 Neubardt Seth L Electrically insulated surgical probing tool
US7087053B2 (en) 2004-05-27 2006-08-08 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter with bifurcated, collapsible tip for sensing and ablating
WO2006086241A2 (en) 2005-02-04 2006-08-17 Nuvasive, Inc. Methods and apparatus for treating spinal stenosis
US20060195107A1 (en) 2005-02-02 2006-08-31 Jones Bryan S Ultrasonic cutting device
US7107104B2 (en) 2003-05-30 2006-09-12 Medtronic, Inc. Implantable cortical neural lead and method
US20060206178A1 (en) 2005-03-11 2006-09-14 Kim Daniel H Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment
EP1006885B1 (en) 1996-10-23 2006-09-20 Oratec Interventions, Inc. Apparatus for treating intervertebral discs
WO2006102085A2 (en) 2005-03-18 2006-09-28 Alphaspine, Inc. Less invasive access port system and method for using the same
US20060224060A1 (en) 2005-03-31 2006-10-05 Garell P C Neural probe array
US7118576B2 (en) 2002-05-15 2006-10-10 Nevmet Corporation Multiportal device with linked cannulae and method for percutaneous surgery
US20060241648A1 (en) * 2005-02-04 2006-10-26 Bleich Jeffery L Methods and apparatus for tissue modification
US20060258951A1 (en) 2005-05-16 2006-11-16 Baxano, Inc. Spinal Access and Neural Localization
US20060264952A1 (en) 2005-05-18 2006-11-23 Nelson Charles L Methods of Using Minimally Invasive Actuable Bone Fixation Devices
WO2006058079A3 (en) 2004-11-22 2006-11-30 Endius Inc Expandable device for providing access to the spine
US20060276720A1 (en) 2005-06-03 2006-12-07 Mcginnis William C Method of using dermatomal somatosensory evoked potentials in real-time for surgical and clinical management
US20060276802A1 (en) 2005-03-29 2006-12-07 Edward Vresilovic Method and apparatus for implanting a hydrogel prosthesis for a nucleus pulposus
US20060276836A1 (en) 2005-06-07 2006-12-07 Bergin Patrick J Hemostatic wire guided bandage and method of use
US20070010717A1 (en) 2000-02-16 2007-01-11 Cragg Andrew H Methods of performing procedures in the spine
US20070016185A1 (en) 2005-04-29 2007-01-18 Tullis Philip J Medical Bipolar Electrode Assembly With A Cannula Having A Bipolar Active Tip And A Separate Supply Electrode And Medical Monopolar Electrode Assembly With A Cannula Having A Monopolar Active Tip And A Separate Temperature-Transducer Post
US20070016097A1 (en) 2003-01-15 2007-01-18 Nuvasive, Inc. System and methods for determining nerve direction to a surgical instrument
WO2007008709A2 (en) 2005-07-12 2007-01-18 Kyphon Inc. Measurement instrument for percutaneous surgery
US7166107B2 (en) 2000-09-11 2007-01-23 D. Greg Anderson Percutaneous technique and implant for expanding the spinal canal
US7166073B2 (en) 2000-09-29 2007-01-23 Stephen Ritland Method and device for microsurgical intermuscular spinal surgery
US7169107B2 (en) 2002-01-25 2007-01-30 Karen Jersey-Willuhn Conductivity reconstruction based on inverse finite element measurements in a tissue monitoring system
US20070027514A1 (en) 2005-07-29 2007-02-01 Medtronic, Inc. Electrical stimulation lead with conformable array of electrodes
US20070027464A1 (en) 2005-07-29 2007-02-01 X-Sten, Corp. Device for resecting spinal tissue
WO2007021588A1 (en) 2005-08-12 2007-02-22 Stryker Spine System and method for spinal implant placement
WO2007022194A2 (en) 2005-08-16 2007-02-22 Benvenue Medical, Inc. Spinal tissue distraction devices
US20070055263A1 (en) 2005-07-29 2007-03-08 X-Sten Corp. Tools for Percutaneous Spinal Ligament Decompression and Device for Supporting Same
US20070055262A1 (en) 2005-05-10 2007-03-08 Mani., Inc. Surgical saw
US20070073356A1 (en) 2005-06-09 2007-03-29 Medtronic, Inc. Combination therapy including peripheral nerve field stimulation
US7198626B2 (en) 2000-12-07 2007-04-03 Rubicor Medical, Inc. Methods and devices for radiofrequency electrosurgery
US7198598B2 (en) 1996-03-22 2007-04-03 Warsaw Orthopedic, Inc. Devices and methods for percutaneous surgery
US7207949B2 (en) 2003-09-25 2007-04-24 Nuvasive, Inc. Surgical access system and related methods
US7211082B2 (en) 1998-09-11 2007-05-01 Stereotaxis, Inc. Magnetically navigable telescoping catheter and method of navigating telescoping catheter
US7214186B2 (en) 2000-09-29 2007-05-08 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US7216001B2 (en) 2003-01-22 2007-05-08 Medtronic Xomed, Inc. Apparatus for intraoperative neural monitoring
US20070106219A1 (en) 2005-10-31 2007-05-10 Andreas Grabinsky Cleveland round tip (CRT) needle
WO2007059343A2 (en) 2005-11-16 2007-05-24 Boston Scientific Neuromodulation Corporation Implantable stimulator configured to be implanted within a patient in a pre-determined orientation
US7223278B2 (en) 1998-08-20 2007-05-29 Endius, Inc. Cannula for receiving surgical instruments
US20070123766A1 (en) 2005-09-29 2007-05-31 Whalen John J Iii Microelectrode systems for neuro-stimulation and neuro-sensing and microchip packaging and related methods
US20070123888A1 (en) 2004-10-15 2007-05-31 Baxano, Inc. Flexible tissue rasp
US20070123890A1 (en) 2005-11-04 2007-05-31 X-Sten, Corp. Tissue retrieval devices and methods
WO2007067632A2 (en) 2005-12-06 2007-06-14 Epi-Sci, Llc Method and system for detecting electrophysiological changes in pre-cancerous and cancerous tissue and epithelium
US7236832B2 (en) 2002-12-09 2007-06-26 Val-Chum, Societe En Commandite Neuromuscular monitoring using phonomyography
US7239911B2 (en) 2002-07-08 2007-07-03 Siemens Aktiengesellschaft Method for localizing at least one focal lesion in a biological tissue section
US20070162062A1 (en) 2005-12-08 2007-07-12 Norton Britt K Reciprocating apparatus and methods for removal of intervertebral disc tissues
US20070162044A1 (en) 2005-11-23 2007-07-12 Trinity Orthopedics Percutaneous transpedicular access, fusion, discectomy, and stabilization system and method
US20070162061A1 (en) 2005-11-04 2007-07-12 X-Sten, Corp. Tissue excision devices and methods
US20070166345A1 (en) 2003-11-28 2007-07-19 Dusan Pavcnik Vascular occlusion methods, systems and devices
US20070213584A1 (en) 2006-03-10 2007-09-13 Kim Daniel H Percutaneous access and visualization of the spine
US20070213583A1 (en) 2006-03-10 2007-09-13 Kim Daniel H Percutaneous access and visualization of the spine
US20070213735A1 (en) 2004-10-15 2007-09-13 Vahid Saadat Powered tissue modification devices and methods
US20070213734A1 (en) 2006-03-13 2007-09-13 Bleich Jeffery L Tissue modification barrier devices and methods
US20070213733A1 (en) 2004-10-15 2007-09-13 Bleich Jeffery L Mechanical tissue modification devices and methods
US7270658B2 (en) 2000-05-12 2007-09-18 Arthrocare Corporation Systems and methods for electrosurgery
US20070225703A1 (en) 2005-10-15 2007-09-27 Baxano, Inc. Flexible Tissue Removal Devices and Methods
US20070255162A1 (en) 2005-11-18 2007-11-01 Marwan Abboud Bioimpedance measurement system and method
US20070255369A1 (en) 2006-04-28 2007-11-01 Bonde Eric H Multi-electrode peripheral nerve evaluation lead and related system and method of use
US20070260252A1 (en) 2006-05-04 2007-11-08 Baxano, Inc. Tissue Removal with at Least Partially Flexible Devices
US20070270795A1 (en) 2001-04-26 2007-11-22 Francischelli David E Ablation system and method of use
US20070270865A1 (en) 2006-04-05 2007-11-22 Uri Arnin Spinal reamer
US20070276390A1 (en) 2006-05-09 2007-11-29 X-Sten, Inc. Ipsilateral Approach to Minimally Invasive Ligament Decompression Procedure
US20070276286A1 (en) 2006-05-27 2007-11-29 Craig James Miller Device for Tissue Diagnosis and Spatial Tissue Mapping
US20070282217A1 (en) 2006-06-01 2007-12-06 Mcginnis William J Methods & systems for intraoperatively monitoring nerve & muscle frequency latency and amplitude
US20070299403A1 (en) 2006-06-23 2007-12-27 Crowe John E Directional introducer
US20070299459A1 (en) 2006-06-26 2007-12-27 X-Sten Corp. Percutaneous Tissue Access Device
US20080033465A1 (en) 2006-08-01 2008-02-07 Baxano, Inc. Multi-Wire Tissue Cutter
US7337005B2 (en) 2004-09-08 2008-02-26 Spinal Modulations, Inc. Methods for stimulating a nerve root ganglion
US20080051812A1 (en) 2006-08-01 2008-02-28 Baxano, Inc. Multi-Wire Tissue Cutter
US20080058874A1 (en) 2006-09-01 2008-03-06 Randy Westlund Method and apparatus for optimizing vagal nerve stimulation using laryngeal activity
US20080086034A1 (en) 2006-08-29 2008-04-10 Baxano, Inc. Tissue Access Guidewire System and Method
US20080091227A1 (en) 2006-08-25 2008-04-17 Baxano, Inc. Surgical probe and method of making
US20080097465A1 (en) 2006-10-21 2008-04-24 Aaron Rollins Guidewire Manipulation Device
US20080103504A1 (en) 2006-10-30 2008-05-01 Schmitz Gregory P Percutaneous spinal stenosis treatment
US20080119711A1 (en) 2006-11-16 2008-05-22 Suwas Nikumb Neurological probe and method of using same
US20080125709A1 (en) 2003-12-31 2008-05-29 Gregory Waimong Chang Needle catheter
US20080140169A1 (en) 2006-12-06 2008-06-12 Spinal Modulation, Inc. Delivery devices, systems and methods for stimulating nerve tissue on multiple spinal levels
US20080140153A1 (en) 2006-12-06 2008-06-12 Spinal Modulation, Inc. Expandable stimulation leads and methods of use
US20080147084A1 (en) 2006-12-07 2008-06-19 Baxano, Inc. Tissue removal devices and methods
US20080161809A1 (en) 2006-10-03 2008-07-03 Baxano, Inc. Articulating Tissue Cutting Device
US20080161810A1 (en) 2006-10-18 2008-07-03 Warsaw Orthopedic, Inc. Guide and Cutter for Contouring Facet Joints and Methods of Use
US20080200912A1 (en) 2007-02-15 2008-08-21 Long Gary L Electroporation ablation apparatus, system, and method
US20080197024A1 (en) 2003-12-05 2008-08-21 Dexcom, Inc. Analyte sensor
US20080221586A1 (en) 2007-02-09 2008-09-11 Alphatec Spine, Inc. Curviliner spinal access method and device
US20080221383A1 (en) 2007-02-12 2008-09-11 Vertos Medical, Inc. Tissue excision devices and methods
US20080288005A1 (en) 2004-02-27 2008-11-20 Jackson Roger P Orthopedic implant rod reduction tool set and method
US20080319459A1 (en) 2005-12-23 2008-12-25 Azad Al-Najjar Laparoscopic Instrument
US20090018610A1 (en) 2004-10-07 2009-01-15 James Gharib System and methods for assessing the neuromuscular pathway prior to nerve testing
WO2009012265A2 (en) 2007-07-16 2009-01-22 Zimmer Spine, Inc. Surgical site access system and deployment device for same
WO2009018220A1 (en) 2007-07-31 2009-02-05 Zimmer Spine, Inc. Method for stabilizing a facet joint
WO2009021116A2 (en) 2007-08-07 2009-02-12 Synthes (U.S.A.) Dynamic cable system
US7494473B2 (en) 2003-07-30 2009-02-24 Intact Medical Corp. Electrical apparatus and system with improved tissue capture component
US20090054804A1 (en) 2007-04-03 2009-02-26 Nuvasive Inc. Neurophysiologic monitoring system
US20090054941A1 (en) 2007-08-20 2009-02-26 Medtronic, Inc. Stimulation field management
US20090054936A1 (en) 2007-08-20 2009-02-26 Medtronic, Inc. Implantable medical lead with biased electrode
US20090062871A1 (en) 2007-08-27 2009-03-05 Singfatt Chin Balloon cannula system for accessing and visualizing spine and related methods
US7503920B2 (en) 2004-08-11 2009-03-17 Tzony Siegal Spinal surgery system and method
WO2009036156A1 (en) 2007-09-14 2009-03-19 Synthes Usa, Llc Interspinous spacer
US7507218B2 (en) 2004-04-26 2009-03-24 Gyrus Acmi, Inc. Stent with flexible elements
WO2009046046A1 (en) 2007-10-01 2009-04-09 Warsaw Orthopedic, Inc. Flexible members for correcting spinal deformities
US20090105604A1 (en) 2005-02-02 2009-04-23 Nuvasive, Inc. System and Methods for Monitoring During Anterior Surgery
US20090118709A1 (en) 2007-11-06 2009-05-07 Vertos Medical, Inc. A Delaware Corporation Tissue Excision Tool, Kits and Methods of Using the Same
WO2009058566A1 (en) 2007-10-29 2009-05-07 Zimmer Spine, Inc. Minimally invasive interbody device and method
US20090124934A1 (en) 2007-11-09 2009-05-14 Abbott Laboratories Guidewire torque device
US20090138056A1 (en) 2003-12-16 2009-05-28 Depuy Spine, Inc. Methods and devices for minimally invasive spinal fixation element placement
US20090143829A1 (en) 2003-05-16 2009-06-04 Zimmer Spine, Inc. Access device for minimally invasive surgery
US20090143807A1 (en) 2007-12-03 2009-06-04 Vertos Medical, Inc., A Delaware Corporation Percutaneous Devices for Separating Tissue, Kits and Methods of Using the Same
US20090177144A1 (en) 2007-12-17 2009-07-09 California Institute Of Technology Micromachined neural probes
US20090177112A1 (en) 2005-02-02 2009-07-09 James Gharib System and Methods for Performing Neurophysiologic Assessments During Spine Surgery
US20090182382A1 (en) 2006-02-07 2009-07-16 Warsaw Orthopedic, Inc. Surgical instruments and techniques for percutaneous placement of spinal stablization elements
US7617006B2 (en) 2006-04-28 2009-11-10 Medtronic, Inc. Medical electrical lead for spinal cord stimulation
WO2009151926A2 (en) 2008-05-23 2009-12-17 Spine View, Inc. Method and devices for treating spinal stenosis
US7648521B2 (en) 2007-03-15 2010-01-19 Zimmer Spine, Inc. System and method for minimally invasive spinal surgery
US7655026B2 (en) 2006-01-31 2010-02-02 Warsaw Orthopedic, Inc. Expandable spinal rods and methods of use
US20100057087A1 (en) 2004-12-20 2010-03-04 Spinascope, Inc. Surgical instrument for orthopedic surgery
US20100094231A1 (en) 2004-10-15 2010-04-15 Bleich Jeffery L Devices and methods for tissue modification
US20100274250A1 (en) 2008-07-01 2010-10-28 Wallace Michael P Tissue modification devices and methods
US20100331883A1 (en) 2004-10-15 2010-12-30 Schmitz Gregory P Access and tissue modification systems and methods
US20100331900A1 (en) 2009-06-25 2010-12-30 Baxano, Inc. Surgical tools for treatment of spinal stenosis
US20110004207A1 (en) 2004-10-15 2011-01-06 Baxano, Inc. Flexible Neural Localization Devices and Methods
US20110060314A1 (en) 2004-10-15 2011-03-10 Wallace Michael P Devices and methods for treating tissue
US20110112539A1 (en) 2008-07-14 2011-05-12 Wallace Michael P Tissue modification devices
US20110160731A1 (en) 2004-10-15 2011-06-30 Bleich Jeffery L Devices and methods for tissue access
US20110190772A1 (en) 2004-10-15 2011-08-04 Vahid Saadat Powered tissue modification devices and methods
US20110196257A1 (en) 2007-09-06 2011-08-11 Schmitz Gregory P Method, system and apparatus for neural localization
US20110224709A1 (en) 2004-10-15 2011-09-15 Bleich Jeffery L Methods, systems and devices for carpal tunnel release

Patent Citations (712)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1938200A (en) 1933-12-05 Band-saw operating mechanism
US289104A (en) 1883-11-27 Combined rasp and saw
USRE25582E (en) 1964-05-19 D a vi es
US184804A (en) 1876-11-28 Improvement in surgical saws
US863389A (en) 1906-06-07 1907-08-13 E N Dickerson Flexible file.
US1039487A (en) 1912-03-09 1912-09-24 Williams Patent Crusher & Pulv Abrasive.
US1201467A (en) 1915-04-26 1916-10-17 Emil J Hoglund Bone-cutting instrument.
US1374638A (en) 1920-01-06 1921-04-12 Cew Charles A De Hand power-driven band-saw
US1543195A (en) 1921-07-07 1925-06-23 Thygesen Jens Peter Nielsen Device for cutting up fetal and like objects in animals
US1690812A (en) 1927-10-08 1928-11-06 John P Benning File
US2243757A (en) 1939-11-09 1941-05-27 Continental Machines File band
US2269749A (en) 1940-09-16 1942-01-13 Continental Machines File band
US2372553A (en) 1942-06-11 1945-03-27 Continental Machines File band
US2437697A (en) 1946-04-01 1948-03-16 Kalom Lawrence Electrical probe
US2516882A (en) 1948-01-22 1950-08-01 Kalom Lawrence Electrical probe
US2982005A (en) 1952-02-06 1961-05-02 Simmonds Aerocessories Ltd Cutting and abrading machines
US2704064A (en) 1952-09-10 1955-03-15 Meditron Company Neurosurgical stimulator
US2820281A (en) 1956-11-30 1958-01-21 Red Devil Tools Abrasive article
US2843128A (en) 1957-03-18 1958-07-15 Storz Instr Co Adenotome
US3150470A (en) 1961-08-11 1964-09-29 Lee H Barron Diamond coated wire saw
US3200814A (en) 1963-03-12 1965-08-17 Ellis R Taylor Apparatus for measuring reflexes, tremors and the like
US3528152A (en) 1966-03-17 1970-09-15 Shinnosuke Funakubo Band-type file
US3495590A (en) 1967-03-15 1970-02-17 Warren Zeiller Surgical cast and cast removal saw
US3389447A (en) 1967-05-26 1968-06-25 Theobald Elwin Omnidirectional cutting tool
US3491776A (en) 1967-06-08 1970-01-27 Floxite Co Inc Dental cleaner for the removal of tobacco and other stains from teeth
US3624484A (en) 1968-12-13 1971-11-30 Wellcome Foundation Ltd Inc Th Oscillator output circuit configuration
US3682162A (en) 1968-12-13 1972-08-08 Wellcome Found Combined electrode and hypodermic syringe needle
US3640280A (en) 1969-11-26 1972-02-08 Daniel R Slanker Power-driven reciprocating bone surgery instrument
US3752166A (en) 1969-12-24 1973-08-14 American Filtrona Corp Tobacco smoke filter
US3651844A (en) 1970-02-24 1972-03-28 Terry B C Barnes All purpose saw
US3664329A (en) 1970-03-09 1972-05-23 Concept Nerve locator/stimulator
US3699729A (en) 1971-05-14 1972-10-24 Carrier Craft Corp Sanding hand tool
US3774355A (en) 1971-10-15 1973-11-27 Remington Arms Co Inc Armored metal file band and production thereof
US3835859A (en) 1973-02-22 1974-09-17 R Roberts Surgical instrument
US3830226A (en) 1973-06-15 1974-08-20 Concept Variable output nerve locator
US3956858A (en) 1973-11-23 1976-05-18 Remington Arms Company, Inc. Flexible hand held abrading tool
US3978862A (en) 1974-08-26 1976-09-07 Stryker Corporation Surgical cutting device
US3957036A (en) 1975-02-03 1976-05-18 Baylor College Of Medicine Method and apparatus for recording activity in intact nerves
US4015931A (en) 1975-09-29 1977-04-05 Engelhard Minerals & Chemicals Corporation Bonded-abrasive wire saw
US4172440A (en) 1976-03-27 1979-10-30 Hoechst Aktiengesellschaft Cutting monofilament
US3999294A (en) 1976-05-07 1976-12-28 George Shoben Flexible bladed saw
US4207897A (en) 1976-07-21 1980-06-17 Spembly Limited Cryosurgical probe
US4099519A (en) 1977-01-14 1978-07-11 Warren Fred E Diagnostic device
US4108182A (en) 1977-02-16 1978-08-22 Concept Inc. Reciprocation vitreous suction cutter head
US4160320A (en) 1977-04-06 1979-07-10 Best & Donovan Hand held band saw
US4259276A (en) 1977-06-24 1981-03-31 Rawlings Derek S Hole forming
US4203444A (en) 1977-11-07 1980-05-20 Dyonics, Inc. Surgical instrument suitable for closed surgery such as of the knee
US4203444B1 (en) 1977-11-07 1987-07-21
US4621636A (en) 1979-07-23 1986-11-11 Fogarty Thomas J Endarterectomy method and apparatus
USD273806S (en) 1981-08-03 1984-05-08 Zimmer, Inc. Reamer/rasp tool, with disposable, debris retaining cutting surface
US4405061A (en) 1981-08-18 1983-09-20 National Instrument Co., Inc. Filling machine
US5147364A (en) 1981-08-20 1992-09-15 Ohio Medical Instrument Company Osteotomy saw/file, cutting guide and method
DE3209403A1 (en) 1982-03-16 1983-09-22 M.A.N. Maschinenfabrik Augsburg-Nürnberg AG, 8000 München Device for making an excavation in a bone
US4545374A (en) 1982-09-03 1985-10-08 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4464836A (en) 1982-09-15 1984-08-14 Hissa Robert E Friction saw and handle assembly
US4518022A (en) 1982-09-29 1985-05-21 Valdes Guillermo A Oscillating cutting element
US4894063A (en) 1983-05-24 1990-01-16 Baxter International Inc. Barrier layer for implantable tendons and ligaments
US4502184A (en) 1983-06-30 1985-03-05 Kentmaster Manufacturing Co., Inc. Reversible carcass saw
US4515168A (en) 1983-07-22 1985-05-07 Chester Martin H Clamp-on nerve stimulator and locator
US4625725A (en) 1983-08-30 1986-12-02 Snowden-Pencer, Inc. Surgical rasp and method of manufacture
US4573448A (en) 1983-10-05 1986-03-04 Pilling Co. Method for decompressing herniated intervertebral discs
US4580545A (en) 1984-02-29 1986-04-08 Florida Wire And Cable Company Stone sawing strand
USRE33258E (en) 1984-07-23 1990-07-10 Surgical Dynamics Inc. Irrigating, cutting and aspirating system for percutaneous surgery
US4678459A (en) 1984-07-23 1987-07-07 E-Z-Em, Inc. Irrigating, cutting and aspirating system for percutaneous surgery
US4590949A (en) 1984-11-01 1986-05-27 Cordis Corporation Neural stimulating lead with stabilizing mechanism and method for using same
US4690642A (en) 1984-11-09 1987-09-01 G-C Dental Industrial Corp. Dental polishing strip
US4616660A (en) 1984-12-10 1986-10-14 Suncoast Medical Manufacturing, Inc. Variable alternating current output nerve locator/stimulator
US4741343A (en) 1985-05-06 1988-05-03 Massachusetts Institute Of Technology Method and apparatus for measuring oxygen partial pressure and temperature in living tissue
US4660571A (en) 1985-07-18 1987-04-28 Cordis Corporation Percutaneous lead having radially adjustable electrode
US4817628A (en) 1985-10-18 1989-04-04 David L. Zealear System and method for evaluating neurological function controlling muscular movements
US4700702A (en) 1985-12-09 1987-10-20 Tatiana Nilsson Instrument for cutting tissues in surgery
US4794931A (en) 1986-02-28 1989-01-03 Cardiovascular Imaging Systems, Inc. Catheter apparatus, system and method for intravascular two-dimensional ultrasonography
US5078137A (en) 1986-05-05 1992-01-07 Massachusetts Institute Of Technology Apparatus for measuring oxygen partial pressure and temperature, in living tissue
US4709699A (en) 1986-08-06 1987-12-01 Fort Wayne Metals Research Products Corporation Surgeon's Gigli saw and method
US4750249A (en) 1986-09-08 1988-06-14 Richardson Henry A Pipe scraping tool
US5025787A (en) 1986-10-08 1991-06-25 The Imperial College Of Science, Technology & Medicine Intrauterine probe
US5019082A (en) 1987-01-08 1991-05-28 Sulzer Brothers Limited Rasp-like reaming instrument
US4808157A (en) 1987-07-13 1989-02-28 Neuro Delivery Technology, Inc. Multi-lumen epidural-spinal needle
US4856193A (en) 1987-07-24 1989-08-15 Grachan Ronald A Saw
US5534009A (en) 1987-10-13 1996-07-09 United States Surgical Corporation Trocar assembly with rotatable tip
US4873978A (en) 1987-12-04 1989-10-17 Robert Ginsburg Device and method for emboli retrieval
US4883460A (en) 1988-04-25 1989-11-28 Zanetti Paul H Technique for removing deposits from body vessels
US4973329A (en) 1988-05-16 1990-11-27 Medical Innovations Corporation Assembly of wire inserter and lock for a medical wire
US4867155A (en) 1988-06-21 1989-09-19 Nu-Tech Industries, Inc. Arthroscopic cutting device
US4943295A (en) 1988-07-13 1990-07-24 Hartlaub Thaddeus J Surgical cutting tool
US4994072A (en) 1988-08-31 1991-02-19 Meadox Medicals, Inc. Dilation catheter
US5178161A (en) 1988-09-02 1993-01-12 The Board Of Trustees Of The Leland Stanford Junior University Microelectronic interface
US4994036A (en) 1988-09-09 1991-02-19 B. Braun Melsungen Ag Catheter set for spinal anaesthesia
US4957117A (en) 1988-11-03 1990-09-18 Ramsey Foundation One-handed percutaneous transluminal angioplasty steering device and method
US5423331A (en) 1988-11-03 1995-06-13 Ramsey Foundation One-handed angioplasty steering device and method
US4946462A (en) 1988-12-12 1990-08-07 Watanabe Robert S Arthroscopic guide and method
US5026386A (en) 1988-12-23 1991-06-25 Michelson Gary K Flaval separator
US4872452A (en) 1989-01-09 1989-10-10 Minnesota Mining And Manufacturing Company Bone rasp
US4990148A (en) 1989-01-13 1991-02-05 Codman & Shurtleff, Inc. Thin footplate rongeur
US4912799A (en) 1989-01-30 1990-04-03 Coleman Jr Lewis E Water main scraper
US5125928A (en) 1989-04-13 1992-06-30 Everest Medical Corporation Ablation catheter with selectively deployable electrodes
US4962766A (en) 1989-07-19 1990-10-16 Herzon Garrett D Nerve locator and stimulator
US5865844A (en) 1989-08-18 1999-02-02 Endovascular Instruments, Inc. Anti-stenotic method and product for occluded and partially occluded arteries
US7011663B2 (en) 1989-08-28 2006-03-14 Gary Karlin Michelson Surgical rongeur having a removable storage member
US5201704A (en) 1989-11-07 1993-04-13 Ray Joel W Method of making and using a hemostatic agent applicator
US5215105A (en) 1989-11-14 1993-06-01 Custom Medical Concepts, Inc. Method of treating epidural lesions
US5026379A (en) 1989-12-05 1991-06-25 Inbae Yoon Multi-functional instruments and stretchable ligating and occluding devices
US5089003A (en) 1989-12-22 1992-02-18 Zimmer, Inc. Rasp tool including detachable handle member
US5383879A (en) 1990-01-22 1995-01-24 Phillips; Arnold G. Bone wax applicator and method for dressing bone tissue
US4995200A (en) 1990-02-27 1991-02-26 Edward Eberhart Sanding tool
US5813405A (en) 1990-04-18 1998-09-29 Cordis Corporation Snap-in connection assembly for extension guidewire system
US5191888A (en) 1990-04-18 1993-03-09 Cordis Corporation Assembly of an extension guidewire and an alignment tool for same
US5100424A (en) 1990-05-21 1992-03-31 Cardiovascular Imaging Systems, Inc. Intravascular catheter having combined imaging abrasion head
US6468289B1 (en) 1990-06-28 2002-10-22 Peter M. Bonutti Apparatus and method for tissue removal
US5300077A (en) 1990-07-16 1994-04-05 Arthrotek Method and instruments for ACL reconstruction
US5374261A (en) 1990-07-24 1994-12-20 Yoon; Inbae Multifunctional devices for use in endoscopic surgical procedures and methods-therefor
JP2960140B2 (en) 1990-10-02 1999-10-06 ユニチカ株式会社 Surgical suture assembly
US5353802A (en) 1990-10-18 1994-10-11 Centrum For Dentalteknik Och Biomaterial Device for measurement of electrical impedance of organic and biological materials
US5195507A (en) 1990-11-06 1993-03-23 Ethicon, Inc. Endoscopic surgical instrument for displacing tissue or organs
US5108403A (en) 1990-11-09 1992-04-28 Stern Mark S Bone waxing device
DE4036804A1 (en) 1990-11-19 1992-05-21 Univ Halle Wittenberg Instruments for decompression of cervical narrow spinal channel - act to remove dorsal edge points of vertebrae and ventral bridge building of damaged segments
US5387218A (en) 1990-12-06 1995-02-07 University College London Surgical instrument for shaping a bone
US5176649A (en) 1991-01-28 1993-01-05 Akio Wakabayashi Insertion device for use with curved, rigid endoscopic instruments and the like
US5456254A (en) 1991-02-15 1995-10-10 Cardiac Pathways Corp Flexible strip assembly having insulating layer with conductive pads exposed through insulating layer and device utilizing the same
US5234435A (en) 1991-03-08 1993-08-10 Seagrave Jr Richard A Surgical method and apparatus
US5163939A (en) 1991-06-27 1992-11-17 Frederick Winston Disk flow and methods therefor
US5152749A (en) 1991-06-28 1992-10-06 American Medical Systems, Inc. Instrument placement apparatus
US5178145A (en) 1991-07-24 1993-01-12 Rea James L Self retaining laryngeal surface electrode and method for independent identification of human recurrent laryngeal nerve
US5219358A (en) 1991-08-29 1993-06-15 Ethicon, Inc. Shape memory effect surgical needles
US5161534A (en) 1991-09-05 1992-11-10 C. R. Bard, Inc. Tool for manipulating a medical guidewire
US5515848A (en) 1991-10-22 1996-05-14 Pi Medical Corporation Implantable microelectrode
US5762629A (en) 1991-10-30 1998-06-09 Smith & Nephew, Inc. Oval cannula assembly and method of use
US5255691A (en) 1991-11-13 1993-10-26 Medtronic, Inc. Percutaneous epidural lead introducing system and method
US5353789A (en) 1991-11-21 1994-10-11 Dragerwerk Ag A flaccid mask with straps and a supporting element that force the mask into sealing engagement with the wearer's face in response to force exerted by the straps on the supporting element
US5271415A (en) 1992-01-28 1993-12-21 Baxter International Inc. Guidewire extension system
US5454815A (en) 1992-04-01 1995-10-03 Imt Integral Medizintechnik Trading Ag Bone rasp made of plastics
US5396880A (en) 1992-04-08 1995-03-14 Danek Medical, Inc. Endoscope for direct visualization of the spine and epidural space
US5284154A (en) 1992-04-14 1994-02-08 Brigham And Women's Hospital Apparatus for locating a nerve and for protecting nerves from injury during surgery
US5284153A (en) 1992-04-14 1994-02-08 Brigham And Women's Hospital Method for locating a nerve and for protecting nerves from injury during surgery
US5250035A (en) 1992-04-20 1993-10-05 Abbott Laboratories Cannula and stylet system
US5571181A (en) 1992-05-11 1996-11-05 Li; Shu-Tung Soft tissue closure systems
US5242418A (en) 1992-05-22 1993-09-07 Weinstein James D Protective means for a needle or similar cannula medical device
US5281218A (en) 1992-06-05 1994-01-25 Cardiac Pathways Corporation Catheter having needle electrode for radiofrequency ablation
US6272367B1 (en) 1992-06-17 2001-08-07 Non-Invasive Technology, Inc. Examination of a biological tissue using photon migration between a plurality of input and detection locations
US5807263A (en) 1992-06-17 1998-09-15 Non-Invasivie Technology, Inc. Imaging of biological tissue using photon migration with high directionality techniques
US5341807A (en) 1992-06-30 1994-08-30 American Cardiac Ablation Co., Inc. Ablation catheter positioning system
US6010493A (en) 1992-07-06 2000-01-04 Catheter Imaging Systems Method of epidural surgery
US6464682B1 (en) 1992-07-06 2002-10-15 Catheter Imaging Systems, Inc. Method of epidural surgery
US6470209B2 (en) 1992-07-06 2002-10-22 Catheter Imaging Systems, Inc. System for enhancing visibility in the epidural space
US5554110A (en) 1992-08-12 1996-09-10 Vidamed, Inc. Medical ablation apparatus
US5351679A (en) 1992-08-17 1994-10-04 Ilya Mayzels Surgical endoscopic retractor instrument
US5360441A (en) 1992-10-30 1994-11-01 Medtronic, Inc. Lead with stylet capture member
US6454767B2 (en) 1992-11-12 2002-09-24 Neville Alleyne Protection device
US5365928A (en) 1992-11-25 1994-11-22 Medrad, Inc. Endorectal probe with planar moveable MRI coil
US5735792A (en) 1992-11-25 1998-04-07 Clarus Medical Systems, Inc. Surgical instrument including viewing optics and an atraumatic probe
US5385146A (en) 1993-01-08 1995-01-31 Goldreyer; Bruce N. Orthogonal sensing for use in clinical electrophysiology
US5582618A (en) 1993-01-12 1996-12-10 R.J. Surgical Instruments, Inc. Surgical cutting instrument
US5833692A (en) 1993-01-29 1998-11-10 Smith & Nephew, Inc. Surgical instrument
US5620447A (en) 1993-01-29 1997-04-15 Smith & Nephew Dyonics Inc. Surgical instrument
US5643304A (en) 1993-02-16 1997-07-01 Danek Medical, Inc. Method and apparatus for minimally invasive tissue removal
US5439464A (en) 1993-03-09 1995-08-08 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
US6491646B1 (en) 1993-03-11 2002-12-10 Lake Region Manufacturing, Inc. Guidewire extension system
US5353784A (en) 1993-04-02 1994-10-11 The Research Foundation Of Suny Endoscopic device and method of use
US5325868A (en) 1993-05-04 1994-07-05 Kimmelstiel Carey D Self-gripping medical wire torquer
US5810744A (en) 1993-05-17 1998-09-22 Boston Scientific Corporation Instrument for collecting multiple biopsy specimens
US5531749A (en) 1993-06-10 1996-07-02 Gary K. Michelson Spinal bone waxer
US5681324A (en) 1993-06-16 1997-10-28 Ethicon, Inc. Surgical tissue retrieval instrument
FR2706309B1 (en) 1993-06-17 1995-10-06 Sofamor Instrument for surgical treatment of an intervertebral disc by the anterior route.
US5441044A (en) 1993-08-16 1995-08-15 United States Surgical Corporation Surgical retractor
US5441510A (en) 1993-09-01 1995-08-15 Technology Development Center Bi-axial cutter apparatus for catheter
US5651373A (en) 1993-09-24 1997-07-29 Cardiometrics, Inc. Extension device, assembly thereof, heater for use therewith and method
US5800350A (en) 1993-11-01 1998-09-01 Polartechnics, Limited Apparatus for tissue type recognition
US5421348A (en) 1993-11-29 1995-06-06 Cordis Corporation Rotating guidewire extension system with mechanically locking extension wire
US6370435B2 (en) 1994-01-28 2002-04-09 Ep Technologies, Inc. Systems and methods for examining the electrical characteristic of cardiac tissue
US6597955B2 (en) 1994-01-28 2003-07-22 Ep Technologies, Inc. Systems and methods for examining the electrical characteristic of cardiac tissue
US6256540B1 (en) 1994-01-28 2001-07-03 Ep Technologies Systems and methods for examining the electrical characteristic of cardiac tissue
US5560372A (en) 1994-02-02 1996-10-01 Cory; Philip C. Non-invasive, peripheral nerve mapping device and method of use
US5755732A (en) 1994-03-16 1998-05-26 United States Surgical Corporation Surgical instruments useful for endoscopic spinal procedures
US5697889A (en) 1994-03-16 1997-12-16 Gus J. Slotman Surgical instruments useful for endoscopic spinal procedures
US5437661A (en) 1994-03-23 1995-08-01 Rieser; Bernhard Method for removal of prolapsed nucleus pulposus material on an intervertebral disc using a laser
US20020016555A1 (en) 1994-03-24 2002-02-07 Ritchart Mark A. Methods and devices for automated biopsy and collection of soft tissue
US5598848A (en) 1994-03-31 1997-02-04 Ep Technologies, Inc. Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium
US5546958A (en) 1994-03-31 1996-08-20 Lake Region Manufacturing Company, Inc. Guidewire extension system with tactile connection indication
US5512037A (en) 1994-05-12 1996-04-30 United States Surgical Corporation Percutaneous surgical retractor
USRE38335E1 (en) 1994-05-24 2003-11-25 Endius Incorporated Surgical instrument
US5680860A (en) 1994-07-07 1997-10-28 Cardiac Pathways Corporation Mapping and/or ablation catheter with coilable distal extremity and method for using same
US5897583A (en) 1994-07-13 1999-04-27 Fraunhofer Gesellschaft Zur Forderung Der Angewandten Forschung E.V. Flexible artificial nerve plates
US5496325A (en) 1994-08-09 1996-03-05 Mclees; Donald J. Split stem surgical saw blade
US5899909A (en) 1994-08-30 1999-05-04 Medscand Medical Ab Surgical instrument for treating female urinary incontinence
US5634475A (en) 1994-09-01 1997-06-03 Datascope Investment Corp. Guidewire delivery assist device and system
RU2107459C1 (en) 1994-09-29 1998-03-27 Нижегородский государственный научно-исследовательский институт травматологии и ортопедии Method and device for searching nerves and plexus nervosus
US5803902A (en) 1994-10-06 1998-09-08 United States Surgical Corporation Surgical retractor
US5656012A (en) 1994-10-06 1997-08-12 United States Surgical Corporation Surgical retractor
US5851214A (en) 1994-10-07 1998-12-22 United States Surgical Corporation Surgical instrument useful for endoscopic procedures
US6142994A (en) 1994-10-07 2000-11-07 Ep Technologies, Inc. Surgical method and apparatus for positioning a diagnostic a therapeutic element within the body
US7141019B2 (en) 1994-10-24 2006-11-28 Mirabel Medical Systems Ltd. Tissue characterization based on impedance images and on impedance measurements
US6678552B2 (en) 1994-10-24 2004-01-13 Transscan Medical Ltd. Tissue characterization based on impedance images and on impedance measurements
US5555892A (en) 1994-11-14 1996-09-17 Tipton; Clyde C. Biopsy shaver
US5868767A (en) 1994-12-23 1999-02-09 Devices For Vascular Intervention Universal catheter with interchangeable work element
US5562695A (en) 1995-01-10 1996-10-08 Obenchain; Theodore G. Nerve deflecting conduit needle and method
US5879353A (en) 1995-01-17 1999-03-09 Gore Enterprise Holdings, Inc. Guided bone rasp
US6540761B2 (en) 1995-01-23 2003-04-01 Russell A. Houser Tissue cutting/tissue removing device with vacuum feature
US6872204B2 (en) 1995-01-23 2005-03-29 Russell A. Tissue cutting catheter and RF cutting method
US5928159A (en) 1995-03-03 1999-07-27 Neothermia Corporation Apparatus and method for characterization and treatment of tumors
US5630426A (en) 1995-03-03 1997-05-20 Neovision Corporation Apparatus and method for characterization and treatment of tumors
US5795308A (en) 1995-03-09 1998-08-18 Russin; Lincoln D. Apparatus for coaxial breast biopsy
US5843110A (en) 1995-03-29 1998-12-01 Linvatec Corporation Apparatus and method for harvesting a bone-tendon-bone ligament graft
US5830151A (en) 1995-04-10 1998-11-03 Innovative Design Associates Apparatus for locating and anesthetizing peripheral nerves a method therefor
US20040024399A1 (en) 1995-04-13 2004-02-05 Arthrocare Corporation Method for repairing damaged intervertebral discs
US6772012B2 (en) 1995-06-07 2004-08-03 Arthrocare Corporation Methods for electrosurgical treatment of spinal tissue
US5775331A (en) 1995-06-07 1998-07-07 Uromed Corporation Apparatus and method for locating a nerve
US20030130655A1 (en) 1995-06-07 2003-07-10 Arthrocare Corporation Electrosurgical systems and methods for removing and modifying tissue
US20060095026A1 (en) 1995-06-07 2006-05-04 Arthrocare Corporation Methods for electrosurgical treatment of spinal tissue
US6205360B1 (en) 1995-09-07 2001-03-20 Cochlear Limited Apparatus and method for automatically determining stimulation parameters
US5846244A (en) 1995-09-18 1998-12-08 Exactech, Inc. Counter-balanced oscillating surgical saw
US5709697A (en) 1995-11-22 1998-01-20 United States Surgical Corporation Apparatus and method for removing tissue
US5824040A (en) 1995-12-01 1998-10-20 Medtronic, Inc. Endoluminal prostheses and therapies for highly variable body lumens
US5846196A (en) 1995-12-13 1998-12-08 Cordis Europa N.V. Intravascular multielectrode cardiac mapping probe
US6015406A (en) 1996-01-09 2000-01-18 Gyrus Medical Limited Electrosurgical instrument
US5766168A (en) 1996-01-11 1998-06-16 Northgate Technologies, Inc. Perforated resectoscope electrode assembly
US5885219A (en) 1996-01-16 1999-03-23 Nightengale; Christopher Interrogation device and method
US5851209A (en) 1996-01-16 1998-12-22 Hospital For Joint Diseases Bone cerclage tool
US5779642A (en) 1996-01-16 1998-07-14 Nightengale; Christopher Interrogation device and method
US6266551B1 (en) 1996-02-15 2001-07-24 Biosense, Inc. Catheter calibration and usage monitoring system
US6068642A (en) 1996-03-01 2000-05-30 Orthopaedic Innovations, Inc. Flexible cutting tool and methods for its use
US5895417A (en) 1996-03-06 1999-04-20 Cardiac Pathways Corporation Deflectable loop design for a linear lesion ablation apparatus
US6520907B1 (en) 1996-03-22 2003-02-18 Sdgi Holdings, Inc. Methods for accessing the spinal column
US6425859B1 (en) 1996-03-22 2002-07-30 Sdgi Holdings, Inc. Cannula and a retractor for percutaneous surgery
WO1997034536A2 (en) 1996-03-22 1997-09-25 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US7198598B2 (en) 1996-03-22 2007-04-03 Warsaw Orthopedic, Inc. Devices and methods for percutaneous surgery
US5792044A (en) 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5788653A (en) 1996-04-03 1998-08-04 Cordis Corporation Guidewire extension with sliding release mechanism
US6038480A (en) 1996-04-04 2000-03-14 Medtronic, Inc. Living tissue stimulation and recording techniques with local control of active sites
EP1340467A2 (en) 1996-05-09 2003-09-03 Olympus Optical Co., Ltd. A cavity retaining tool for general surgery
US6030383A (en) 1996-05-21 2000-02-29 Benderev; Theodore V. Electrosurgical instrument and method of use
US6364886B1 (en) 1996-06-04 2002-04-02 Joseph H. Sklar Apparatus and method for reconstructing ligaments
US5725530A (en) 1996-06-19 1998-03-10 Popken; John A. Surgical saw and methods therefor
US5853373A (en) 1996-08-05 1998-12-29 Becton, Dickinson And Company Bi-level charge pulse apparatus to facilitate nerve location during peripheral nerve block procedures
US6169916B1 (en) 1996-08-08 2001-01-02 Medtronic Inc. Electrophysiology catheter with multifunctional wire and method for making
US6073051A (en) 1996-08-13 2000-06-06 Oratec Interventions, Inc. Apparatus for treating intervertebal discs with electromagnetic energy
US7282061B2 (en) 1996-08-13 2007-10-16 Oratec Interventions, Inc. Method of treating intervertebral disc
US6099514A (en) 1996-08-13 2000-08-08 Oratec Interventions, Inc. Method and apparatus for delivering or removing material from the interior of an intervertebral disc
US5759159A (en) 1996-09-25 1998-06-02 Ormco Corporation Method and apparatus for apical detection with complex impedance measurement
US6261582B1 (en) 1996-10-15 2001-07-17 C. R. Bard, Inc. Surgical method and composition therefor
EP1006885B1 (en) 1996-10-23 2006-09-20 Oratec Interventions, Inc. Apparatus for treating intervertebral discs
US5830188A (en) 1996-12-11 1998-11-03 Board Of Regents, The University Of Texas System Curved cannula for continuous spinal anesthesia
US7063682B1 (en) 1996-12-19 2006-06-20 Ep Technologies, Inc. Catheter distal assembly with pull wires
US5919190A (en) 1996-12-20 1999-07-06 Vandusseldorp; Gregg A. Cutting loop for an electrocautery probe
US5836948A (en) 1997-01-02 1998-11-17 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US7666209B2 (en) 1997-01-02 2010-02-23 Kyphon Sarl Spine distraction implant and method
US6699246B2 (en) 1997-01-02 2004-03-02 St. Francis Medical Technologies, Inc. Spine distraction implant
US6391028B1 (en) 1997-02-12 2002-05-21 Oratec Interventions, Inc. Probe with distally orientated concave curve for arthroscopic surgery
US5918604A (en) 1997-02-12 1999-07-06 Arthrex, Inc. Method of loading tendons into the knee
US20080125621A1 (en) 1997-02-13 2008-05-29 Scimed Life Systems, Inc. Devices for minimally invasive pelvic surgery
US20080146867A1 (en) 1997-02-13 2008-06-19 Scimed Life Systems, Inc. Devices for minimally invasive pelvic surgery
US6752814B2 (en) 1997-02-13 2004-06-22 Scimed Life Systems, Inc. Devices for minimally invasive pelvic surgery
US6423080B1 (en) 1997-02-13 2002-07-23 Scimed Life Systems, Inc. Percutaneous and hiatal devices and methods for use in minimally invasive pelvic surgery
US5769865A (en) 1997-02-25 1998-06-23 Surgical Insight, Inc. Instrument and method for transection of a ligament
US5904657A (en) 1997-02-26 1999-05-18 Unsworth; John D. System for guiding devices in body lumens
US5916173A (en) 1997-02-26 1999-06-29 Kirsner; Vaclav Methods and apparatus for monitoring fertility status in the mammalian vagina
US6487439B1 (en) 1997-03-17 2002-11-26 Victor N. Skladnev Glove-mounted hybrid probe for tissue type recognition
US5941822A (en) 1997-03-17 1999-08-24 Polartechnics Limited Apparatus for tissue type recognition within a body canal
US5928158A (en) 1997-03-25 1999-07-27 Aristides; Arellano Medical instrument with nerve sensor
US5830157A (en) 1997-05-09 1998-11-03 Merit Medical Systems, Inc. Guidewire connection guide and method of use
US6102930A (en) 1997-05-16 2000-08-15 Simmons, Jr.; Edward D. Volumetric measurement device and method in lateral recess and foraminal spinal stenosis
US20020183647A1 (en) 1997-07-01 2002-12-05 Gozani Shai N. Apparatus and method for performing nerve conduction studies with localization of evoked responses
US5851191A (en) 1997-07-01 1998-12-22 Neurometrix, Inc. Apparatus and methods for assessment of neuromuscular function
US6132387A (en) 1997-07-01 2000-10-17 Neurometrix, Inc. Neuromuscular electrode
US5976146A (en) 1997-07-11 1999-11-02 Olympus Optical Co., Ltd. Surgical operation system and method of securing working space for surgical operation in body
US7041099B2 (en) 1997-07-24 2006-05-09 Western Sydney Area Health Service Intraoperative endocardial and epicardial ablation probe
US6540742B1 (en) 1997-07-24 2003-04-01 Stuart Thomas Intraoperative endocardial and epicardial ablation probe
US6516223B2 (en) 1997-08-01 2003-02-04 Genetronics, Inc. Apparatus for electroporation mediated delivery for drugs and genes
US6004326A (en) 1997-09-10 1999-12-21 United States Surgical Method and instrumentation for implant insertion
US6106558A (en) 1997-09-15 2000-08-22 Applied Medical Research, Inc. Neuro decompression device
US6214001B1 (en) 1997-09-19 2001-04-10 Oratec Interventions, Inc. Electrocauterizing tool for orthopedic shave devices
US5972013A (en) 1997-09-19 1999-10-26 Comedicus Incorporated Direct pericardial access device with deflecting mechanism and method
US6488636B2 (en) 1997-09-19 2002-12-03 United States Surgical Corporation Biopsy apparatus
US6324418B1 (en) 1997-09-29 2001-11-27 Boston Scientific Corporation Portable tissue spectroscopy apparatus and method
WO1999018866A1 (en) 1997-10-14 1999-04-22 Parallax Medical, Inc. Precision instruments for use in vertebroplasty
WO1999021500A1 (en) 1997-10-27 1999-05-06 Saint Francis Medical Technologies, Llc Spine distraction implant
US6152894A (en) 1997-10-27 2000-11-28 Kubler; Harald Surgical cutting instrument
US5803904A (en) 1997-10-28 1998-09-08 Mehdizadeh; Hamid Nerve root retractor and disc space separator
US5961522A (en) 1997-11-10 1999-10-05 Mehdizadeh; Hamid M. Laminectomy chisel and guide apparatus
US6146380A (en) 1998-01-09 2000-11-14 Radionics, Inc. Bent tip electrical surgical probe
US5976110A (en) 1998-01-14 1999-11-02 Duke University Catheter system for administration of continuous peripheral nerve anesthetic
US6446621B1 (en) 1998-01-21 2002-09-10 Hagby Asahi Ab Saw wire
US6370411B1 (en) 1998-02-10 2002-04-09 Biosense, Inc. Catheter calibration
US20040167444A1 (en) 1998-02-13 2004-08-26 Ventrica, Inc., Corporation Of Delaware Placing a guide member into a heart chamber through a coronary vessel and delivering devices for placing the coronary vessel in communication with the heart chamber
US6142993A (en) 1998-02-27 2000-11-07 Ep Technologies, Inc. Collapsible spline structure using a balloon as an expanding actuator
US6113534A (en) 1998-03-19 2000-09-05 Koros; Tibor B. Adjustable heart surface stabilizer
US6527786B1 (en) 1998-04-09 2003-03-04 Origin Medsystems, Inc. System and method of use for ligating and cutting tissue
US6666874B2 (en) 1998-04-10 2003-12-23 Endicor Medical, Inc. Rotational atherectomy system with serrated cutting tip
US6292702B1 (en) 1998-04-30 2001-09-18 Medtronic, Inc. Apparatus and method for expanding a stimulation lead body in situ
US20010053885A1 (en) 1998-04-30 2001-12-20 Frans Gielen Techniques for positioning therapy delivery elements within a spinal cord or a brain
US6267760B1 (en) 1998-05-05 2001-07-31 Scimed Life Systems, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and forming an incision in tissue with minimal blood loss
US6416505B1 (en) 1998-05-05 2002-07-09 Scimed Life Systems, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and pressure application probe for use with same
US6451335B1 (en) 1998-07-02 2002-09-17 Euro-Celtique S.A. Formulations and methods for providing prolonged local anesthesia
US6390906B1 (en) 1998-07-06 2002-05-21 Saint-Gobain Abrasives Technology Company Flexible abrasive belts
US20040054368A1 (en) 1998-07-13 2004-03-18 Novacept Apparatuses and methods for interstitial tissue removal
US6002964A (en) 1998-07-15 1999-12-14 Feler; Claudio A. Epidural nerve root stimulation
US20020029060A1 (en) 1998-07-29 2002-03-07 Michael Hogendijk Surgical cutting instrument and method of use
US7223278B2 (en) 1998-08-20 2007-05-29 Endius, Inc. Cannula for receiving surgical instruments
US6136014A (en) 1998-09-01 2000-10-24 Vivant Medical, Inc. Percutaneous tissue removal device
US6022362A (en) 1998-09-03 2000-02-08 Rubicor Medical, Inc. Excisional biopsy devices and methods
US7211082B2 (en) 1998-09-11 2007-05-01 Stereotaxis, Inc. Magnetically navigable telescoping catheter and method of navigating telescoping catheter
US6030401A (en) 1998-10-07 2000-02-29 Nuvasive, Inc. Vertebral enplate decorticator and osteophyte resector
US6845264B1 (en) 1998-10-08 2005-01-18 Victor Skladnev Apparatus for recognizing tissue types
US6266558B1 (en) 1998-12-01 2001-07-24 Neurometrix, Inc. Apparatus and method for nerve conduction measurements with automatic setting of stimulus intensity
US6592559B1 (en) 1998-12-09 2003-07-15 Cook Incorporated Hollow, curved, superlastic medical needle
US6425887B1 (en) 1998-12-09 2002-07-30 Cook Incorporated Multi-directional needle medical device
US20070049962A1 (en) 1998-12-23 2007-03-01 Nuvasive, Inc. Nerve surveillance cannulae systems
US6564078B1 (en) 1998-12-23 2003-05-13 Nuvasive, Inc. Nerve surveillance cannula systems
US7079883B2 (en) 1998-12-23 2006-07-18 Nuvaslve, Inc. Nerve surveillance cannulae systems
US6280447B1 (en) 1998-12-23 2001-08-28 Nuvasive, Inc. Bony tissue resector
US7014616B2 (en) 1998-12-28 2006-03-21 Micrus Corporation Composite guidewire
US6595932B2 (en) 1998-12-28 2003-07-22 Micrus Corporation Composite guidewire
US6626916B1 (en) 1998-12-31 2003-09-30 Teresa T. Yeung Tissue fastening devices and methods for sustained holding strength
US20040127963A1 (en) 1999-01-25 2004-07-01 Uchida Andy H. Intervertebral decompression
US6442848B1 (en) 1999-03-22 2002-09-03 Ethan Dean Coping saw
US6726531B1 (en) 1999-03-26 2004-04-27 Stephen K. Harrel Abrasive tool having safe and active areas
US6048345A (en) 1999-04-08 2000-04-11 Joseph J. Berke Motorized reciprocating surgical file apparatus and method
US6606523B1 (en) 1999-04-14 2003-08-12 Transneuronix Inc. Gastric stimulator apparatus and method for installing
US6478805B1 (en) 1999-04-16 2002-11-12 Nuvasive, Inc. System for removing cut tissue from the inner bore of a surgical instrument
US6277094B1 (en) 1999-04-28 2001-08-21 Medtronic, Inc. Apparatus and method for dilating ligaments and tissue by the alternating insertion of expandable tubes
US6500189B1 (en) 1999-04-29 2002-12-31 Karl Storz Gmbh & Co. Kg Medical instrument for dissecting tissue
US6360750B1 (en) 1999-04-29 2002-03-26 Medtronic, Inc. Minimally invasive surgical techniques for implanting devices that deliver stimulant to the nervous system
US6251115B1 (en) 1999-04-29 2001-06-26 Medtronic, Inc. Method for the medical treatment of the neurological system
US6214016B1 (en) 1999-04-29 2001-04-10 Medtronic, Inc. Medical instrument positioning device internal to a catheter or lead and method of use
US20010025192A1 (en) 1999-04-29 2001-09-27 Medtronic, Inc. Single and multi-polar implantable lead for sacral nerve electrical stimulation
US6259945B1 (en) 1999-04-30 2001-07-10 Uromed Corporation Method and device for locating a nerve
US6535759B1 (en) 1999-04-30 2003-03-18 Blue Torch Medical Technologies, Inc. Method and device for locating and mapping nerves
US20010014806A1 (en) 1999-05-03 2001-08-16 Ellman Alan G. Electrosurgical handpiece for treating tissue
US6805697B1 (en) 1999-05-07 2004-10-19 University Of Virginia Patent Foundation Method and system for fusing a spinal region
WO2000067651A1 (en) 1999-05-10 2000-11-16 Highgate Orthopedics, Inc. Systems and methods for spinal fixation
US6607530B1 (en) 1999-05-10 2003-08-19 Highgate Orthopedics, Inc. Systems and methods for spinal fixation
US6682535B2 (en) 1999-06-16 2004-01-27 Thomas Hoogland Apparatus for decompressing herniated intervertebral discs
EP1207794B1 (en) 1999-06-16 2004-05-26 joimax GmbH Apparatus for decompressing herniated intervertebral discs
US6343226B1 (en) 1999-06-25 2002-01-29 Neurokinetic Aps Multifunction electrode for neural tissue stimulation
US7189240B1 (en) * 1999-08-01 2007-03-13 Disc-O-Tech Medical Technologies Ltd. Method and apparatus for spinal procedures
WO2001008571A1 (en) 1999-08-01 2001-02-08 Disc-O-Tech Medical Technologies Ltd. Method and apparatus for spinal procedures
US20020022788A1 (en) 1999-08-19 2002-02-21 Tim Corvi Apparatus and methods for material capture and removal
US6638233B2 (en) 1999-08-19 2003-10-28 Fox Hollow Technologies, Inc. Apparatus and methods for material capture and removal
US6997934B2 (en) 1999-08-19 2006-02-14 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US20040181150A1 (en) 1999-09-01 2004-09-16 Bacchus Vascular, Inc. Methods and apparatus for accessing and treating body lumens
US6298256B1 (en) 1999-09-10 2001-10-02 Frank-Egbert Meyer Device and method for the location and catheterization of the surroundings of a nerve
US6334068B1 (en) 1999-09-14 2001-12-25 Medtronic Xomed, Inc. Intraoperative neuroelectrophysiological monitor
US6533749B1 (en) 1999-09-24 2003-03-18 Medtronic Xomed, Inc. Angled rotary tissue cutting instrument with flexible inner member
US6610066B2 (en) 1999-09-24 2003-08-26 Medtronic Xomed, Inc. Suction rasp and handpiece adapter assembly and powered surgical handpiece assembly including a suction rasp
US6368324B1 (en) 1999-09-24 2002-04-09 Medtronic Xomed, Inc. Powered surgical handpiece assemblies and handpiece adapter assemblies
US6236892B1 (en) 1999-10-07 2001-05-22 Claudio A. Feler Spinal cord stimulation lead
US6436101B1 (en) 1999-10-13 2002-08-20 James S. Hamada Rasp for use in spine surgery
US7081122B1 (en) 1999-10-19 2006-07-25 Kyphon Inc. Hand-held instruments that access interior body regions
US20020019637A1 (en) 1999-10-21 2002-02-14 George Frey Devices and techniques for a posterior lateral disc space approach
US6830570B1 (en) 1999-10-21 2004-12-14 Sdgi Holdings, Inc. Devices and techniques for a posterior lateral disc space approach
US20040006391A1 (en) 1999-10-22 2004-01-08 Archus Orthopedics Inc. Facet arthroplasty devices and methods
US6324432B1 (en) 1999-11-01 2001-11-27 Compex Sa Electrical neuromuscular stimulator for measuring muscle responses to electrical stimulation pulses
US6466817B1 (en) 1999-11-24 2002-10-15 Nuvasive, Inc. Nerve proximity and status detection system and method
US7470236B1 (en) 1999-11-24 2008-12-30 Nuvasive, Inc. Electromyography system
US20040199084A1 (en) 1999-11-24 2004-10-07 Nuvasive, Inc. Electromyography system
US20030045808A1 (en) 1999-11-24 2003-03-06 Nuvasive, Inc. Nerve proximity and status detection system and method
US7011635B1 (en) 1999-12-10 2006-03-14 Sedat Manual control device for a surgical guide
US20040162609A1 (en) 1999-12-23 2004-08-19 Hossainy Syed F.A. Coating for implantable devices and a method of forming the same
USD432384S (en) 2000-01-21 2000-10-24 Sandpaper tool
US20040143165A1 (en) 2000-01-21 2004-07-22 Neville Alleyne Intervertebral disc repair methods and apparatus
US6564088B1 (en) 2000-01-21 2003-05-13 University Of Massachusetts Probe for localized tissue spectroscopy
US6632184B1 (en) 2000-02-11 2003-10-14 Regents Of The University Of Minnesota Method and device for deflecting a probe
US6575979B1 (en) 2000-02-16 2003-06-10 Axiamed, Inc. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US20070010717A1 (en) 2000-02-16 2007-01-11 Cragg Andrew H Methods of performing procedures in the spine
US20010049527A1 (en) 2000-02-16 2001-12-06 Cragg Andrew H. Methods and apparatus for performing therapeutic procedures in the spine
US6899716B2 (en) 2000-02-16 2005-05-31 Trans1, Inc. Method and apparatus for spinal augmentation
US7087058B2 (en) 2000-02-16 2006-08-08 Trans1, Inc. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US6790210B1 (en) 2000-02-16 2004-09-14 Trans1, Inc. Methods and apparatus for forming curved axial bores through spinal vertebrae
WO2001062168A2 (en) 2000-02-25 2001-08-30 Oratec Interventions, Inc. Apparatus and method for accessing and performing a function within an intervertebral disc
US6973342B1 (en) 2000-03-02 2005-12-06 Advanced Neuromodulation Systems, Inc. Flexible bio-probe assembly
US20050060006A1 (en) 2000-03-20 2005-03-17 Pflueger D. Russell Epidural nerve root access catheter and treatment methods
US6682536B2 (en) 2000-03-22 2004-01-27 Advanced Stent Technologies, Inc. Guidewire introducer sheath
US6805695B2 (en) 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US20050049592A1 (en) 2000-04-04 2005-03-03 Keith Peter T. Devices and methods for annular repair of intervertebral discs
US6312392B1 (en) 2000-04-06 2001-11-06 Garrett D. Herzon Bipolar handheld nerve locator and evaluator
US6673068B1 (en) 2000-04-12 2004-01-06 Afx, Inc. Electrode arrangement for use in a medical instrument
US6976986B2 (en) 2000-04-12 2005-12-20 Afx, Inc. Electrode arrangement for use in a medical instrument
US20010039419A1 (en) 2000-04-27 2001-11-08 Medtronic, Inc. Vibration sensitive ablation device and method
US6851430B2 (en) 2000-05-01 2005-02-08 Paul M. Tsou Method and apparatus for endoscopic spinal surgery
US7270658B2 (en) 2000-05-12 2007-09-18 Arthrocare Corporation Systems and methods for electrosurgery
US20060224078A1 (en) 2000-05-18 2006-10-05 Nuvasive, Inc. Tissue discrimination and applications in medical procedures
US6760616B2 (en) 2000-05-18 2004-07-06 Nu Vasive, Inc. Tissue discrimination and applications in medical procedures
US7050848B2 (en) 2000-05-18 2006-05-23 Nuvasive, Inc. Tissue discrimination and applications in medical procedures
US6383509B1 (en) 2000-06-02 2002-05-07 Allergan Sales, Inc. Biodegradable neurotoxin implant
US6500128B2 (en) 2000-06-08 2002-12-31 Nuvasive, Inc. Nerve movement and status detection system and method
US20030187368A1 (en) 2000-06-12 2003-10-02 Masataka Sata Medical guide wire doubling as a catheter
US6546270B1 (en) 2000-07-07 2003-04-08 Biosense, Inc. Multi-electrode catheter, system and method
US6569160B1 (en) 2000-07-07 2003-05-27 Biosense, Inc. System and method for detecting electrode-tissue contact
US6882879B2 (en) 2000-07-19 2005-04-19 Innovamedica S.A. De C.V. Impedance spectroscopy system and catheter for ischemic mucosal damage monitoring in hollow viscous organs
US20060015035A1 (en) 2000-07-19 2006-01-19 Rock Emilio S Impedance spectroscopy system for ischemic mucosal damage monitoring in hollow viscous organs
US6423071B1 (en) 2000-07-25 2002-07-23 Kevin Jon Lawson Surgical tool and method for passing pilot-line sutures through spinal vertebrae
WO2002007901A1 (en) 2000-07-25 2002-01-31 Alan Bertram Kingsbury Flexible file and method for making it
US6972199B2 (en) 2000-07-25 2005-12-06 Verimetra, Inc. Method of making a cutting instrument having integrated sensors
US6962587B2 (en) 2000-07-25 2005-11-08 Rita Medical Systems, Inc. Method for detecting and treating tumors using localized impedance measurement
US20030109871A1 (en) 2000-07-25 2003-06-12 Johnson Theodore C. Apparatus for detecting and treating tumors using locaIized impedance measurement
US6609018B2 (en) 2000-07-27 2003-08-19 Ckm Diagnostics, Inc. Electrode array and sensor attachment system for noninvasive nerve location and imaging device
US6564079B1 (en) 2000-07-27 2003-05-13 Ckm Diagnostics, Inc. Electrode array and skin attachment system for noninvasive nerve location and imaging device
US7070596B1 (en) 2000-08-09 2006-07-04 Arthrocare Corporation Electrosurgical apparatus having a curved distal section
US20020022873A1 (en) 2000-08-10 2002-02-21 Erickson John H. Stimulation/sensing lead adapted for percutaneous insertion
US20040133208A1 (en) 2000-09-01 2004-07-08 Synthes (Usa) Tools and methods for creating cavities in bone
EP1315463B1 (en) 2000-09-07 2005-05-11 Sherwood Services AG Apparatus for the treatment of the intervertebral disc
US6358254B1 (en) 2000-09-11 2002-03-19 D. Greg Anderson Method and implant for expanding a spinal canal
US7166107B2 (en) 2000-09-11 2007-01-23 D. Greg Anderson Percutaneous technique and implant for expanding the spinal canal
US6624510B1 (en) 2000-09-28 2003-09-23 University Of Iowa Research Foundation Electrode array having a thin, flexible substrate
US7166073B2 (en) 2000-09-29 2007-01-23 Stephen Ritland Method and device for microsurgical intermuscular spinal surgery
US7214186B2 (en) 2000-09-29 2007-05-08 Stephen Ritland Method and device for retractor for microsurgical intermuscular lumbar arthrodesis
US20040006379A1 (en) 2000-10-06 2004-01-08 Expanding Concepts, L.L.C. Epidural thermal posterior annuloplasty
US20040111084A1 (en) 2000-10-06 2004-06-10 Expanding Concepts, L.L.C. Epidural thermal posterior annuloplasty
US6673063B2 (en) 2000-10-06 2004-01-06 Expanding Concepts, Llc. Epidural thermal posterior annuloplasty
US6579291B1 (en) 2000-10-10 2003-06-17 Spinalabs, Llc Devices and methods for the treatment of spinal disorders
WO2002034120A2 (en) 2000-10-27 2002-05-02 Blackstone Medical, Inc. Facet fixation devices
US7033373B2 (en) 2000-11-03 2006-04-25 Satiety, Inc. Method and device for use in minimally invasive placement of space-occupying intragastric devices
US6847849B2 (en) 2000-11-15 2005-01-25 Medtronic, Inc. Minimally invasive apparatus for implanting a sacral stimulation lead
US20020106681A1 (en) 2000-11-24 2002-08-08 Alvin Wexler High definition electrical impedance tomography methods for the detection and diagnosis of early stages of breast cancer
US7198626B2 (en) 2000-12-07 2007-04-03 Rubicor Medical, Inc. Methods and devices for radiofrequency electrosurgery
US6991643B2 (en) 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US20040167553A1 (en) 2000-12-20 2004-08-26 Fox Hollow Technologies, Inc. Methods and devices for cutting tissue
US7001333B2 (en) 2000-12-20 2006-02-21 Hamel Ross J Surgical retractor system
US6622731B2 (en) 2001-01-11 2003-09-23 Rita Medical Systems, Inc. Bone-treatment instrument and method
US20020165590A1 (en) 2001-01-16 2002-11-07 Crowe Louis Michael Apparatus for stimulating a muscle of a subject
US7048682B2 (en) 2001-01-23 2006-05-23 American Medical Systems, Inc. Surgical articles and methods
US6971986B2 (en) 2001-01-23 2005-12-06 American Medical Systems, Inc. Sling delivery system and method of use
US6558353B2 (en) 2001-01-25 2003-05-06 Walter A. Zohmann Spinal needle
US20040122433A1 (en) 2001-02-06 2004-06-24 Thierry Loubens Endoscopic rongeur-type surgical instrument
US20040097927A1 (en) 2001-02-13 2004-05-20 Yeung Jeffrey E. Intervertebral disc repair
US6929647B2 (en) 2001-02-21 2005-08-16 Howmedica Osteonics Corp. Instrumentation and method for implant insertion
US6584345B2 (en) 2001-03-13 2003-06-24 Biosense, Inc. Apparatus and method for measuring a plurality of electrical signals from the body of a patient
WO2002076311A2 (en) 2001-03-23 2002-10-03 Sdgi Holdings, Inc. Devices and methods for percutaneous surgery
US6890353B2 (en) 2001-03-23 2005-05-10 Viacor, Inc. Method and apparatus for reducing mitral regurgitation
US20020138091A1 (en) 2001-03-23 2002-09-26 Devonrex, Inc. Micro-invasive nucleotomy device and method
US6562033B2 (en) 2001-04-09 2003-05-13 Baylis Medical Co. Intradiscal lesioning apparatus
US20050027199A1 (en) 2001-04-11 2005-02-03 Clarke Dana S. Tissue structure identification in advance of instrument
US20040049179A1 (en) 2001-04-26 2004-03-11 Francischelli David E. Ablation system
US20060142753A1 (en) 2001-04-26 2006-06-29 Medtronic, Inc. Ablation system and method of use
US6648883B2 (en) 2001-04-26 2003-11-18 Medtronic, Inc. Ablation system and method of use
US6512958B1 (en) 2001-04-26 2003-01-28 Medtronic, Inc. Percutaneous medical probe and flexible guide wire
US20070270795A1 (en) 2001-04-26 2007-11-22 Francischelli David E Ablation system and method of use
US6746451B2 (en) 2001-06-01 2004-06-08 Lance M. Middleton Tissue cavitation device and method
US6733496B2 (en) 2001-06-06 2004-05-11 Oratec Interventions, Inc. Intervertebral disc device employing flexible probe
US6726685B2 (en) 2001-06-06 2004-04-27 Oratec Interventions, Inc. Intervertebral disc device employing looped probe
US20030105503A1 (en) 2001-06-08 2003-06-05 Nuvasive, Inc. Relative nerve movement and status detection system and method
US6723049B2 (en) 2001-06-15 2004-04-20 Polartechnics Limited Apparatus for tissue type recognition using multiple measurement techniques
US20030023190A1 (en) 2001-06-20 2003-01-30 Micro Vention, Inc. Medical devices having full or partial polymer coatings and their methods of manufacture
US6884220B2 (en) 2001-06-29 2005-04-26 The Trustees Of Columbia University In The City Of New York Optical transesophageal echocardiography probe
US6832111B2 (en) 2001-07-06 2004-12-14 Hosheng Tu Device for tumor diagnosis and methods thereof
US6620129B2 (en) 2001-07-09 2003-09-16 Eric C. Stecker Enlargeable multifunctional devices
US20050182454A1 (en) 2001-07-11 2005-08-18 Nuvasive, Inc. System and methods for determining nerve proximity, direction, and pathology during surgery
US20090209879A1 (en) 2001-07-11 2009-08-20 Nuvasive, Inc. System and Methods for Determining Nerve Proximity, Direction, and Pathology During Surgery
US6994693B2 (en) 2001-07-17 2006-02-07 Yale University Tunneler-needle combination for tunneled catheter placement
US6911016B2 (en) 2001-08-06 2005-06-28 Scimed Life Systems, Inc. Guidewire extension system
US6776765B2 (en) 2001-08-21 2004-08-17 Synovis Life Technologies, Inc. Steerable stylet
US20030045937A1 (en) * 2001-09-06 2003-03-06 Integrated Vascular Systems, Inc. Apparatus and methods for treating spinal discs
US6736815B2 (en) 2001-09-06 2004-05-18 Core Medical, Inc. Apparatus and methods for treating spinal discs
US20040199159A1 (en) 2001-09-12 2004-10-07 Manoa Medical, Inc., A Delaware Corporation Devices and methods for tissue severing and removal
WO2003026482A2 (en) 2001-09-25 2003-04-03 Nuvasive, Inc. System and methods for performing surgical procedures and assessments
US20050075578A1 (en) 2001-09-25 2005-04-07 James Gharib System and methods for performing surgical procedures and assessments
US20030074037A1 (en) 2001-10-17 2003-04-17 Rehabilicare, Inc. Electrical nerve stimulation device
EP1304080A2 (en) 2001-10-19 2003-04-23 Mani, Inc. Surgical ribbon file
US20030225412A1 (en) 2001-10-19 2003-12-04 Tateru Shiraishi Surgical ribbon file
US6788966B2 (en) 2001-10-22 2004-09-07 Transscan Medical Ltd. Diagnosis probe
US20040064058A1 (en) 2001-10-24 2004-04-01 Mckay William F. Methods and instruments for treating pseudoarthrosis
US7008431B2 (en) 2001-10-30 2006-03-07 Depuy Spine, Inc. Configured and sized cannula
US6807444B2 (en) 2001-11-05 2004-10-19 Hosheng Tu Apparatus and methods for monitoring tissue impedance
US6865409B2 (en) 2001-11-07 2005-03-08 Kinesense, Inc. Surface electromyographic electrode assembly
US20030130738A1 (en) 2001-11-08 2003-07-10 Arthrocare Corporation System and method for repairing a damaged intervertebral disc
US6916328B2 (en) 2001-11-15 2005-07-12 Expanding Concepts, L.L.C Percutaneous cellulite removal system
US20060122653A1 (en) 2001-12-04 2006-06-08 Kerry Bradley Apparatus and method for determining the relative position and orientation of neurostimulation leads
US20060122654A1 (en) 2001-12-04 2006-06-08 Kerry Bradley Apparatus and method for determining the relative position and orientation of neurostimulation leads
US20030113906A1 (en) 2001-12-14 2003-06-19 Sangha Jangbir S. Method and apparatus for DNA collection
US6875221B2 (en) 2001-12-14 2005-04-05 Bausch & Lomb Incorporated Turbine driven vitrectomy cutter
US20030225415A1 (en) 2002-01-18 2003-12-04 Alain Richard Method and apparatus for reconstructing bone surfaces during surgery
US7169107B2 (en) 2002-01-25 2007-01-30 Karen Jersey-Willuhn Conductivity reconstruction based on inverse finite element measurements in a tissue monitoring system
WO2003066147A1 (en) 2002-02-04 2003-08-14 Kaplan Aaron V Methods and apparatus for pericardial access
US20030167021A1 (en) 2002-03-04 2003-09-04 Shimm Peter B. Apparatus for locating and anesthetizing nerve groups
US6911003B2 (en) 2002-03-07 2005-06-28 Ams Research Corporation Transobturator surgical articles and methods
US7070556B2 (en) 2002-03-07 2006-07-04 Ams Research Corporation Transobturator surgical articles and methods
US20030212400A1 (en) 2002-03-12 2003-11-13 Aesculap Ag & Co. Kg Methods for treating spinal stenosis by pedicle distraction
US6736835B2 (en) 2002-03-21 2004-05-18 Depuy Acromed, Inc. Early intervention spinal treatment methods and devices for use therein
US20040049208A1 (en) 2002-04-03 2004-03-11 Thomas Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
US20030188749A1 (en) 2002-04-05 2003-10-09 Nichols Travis R. Systems and methods for endotracheal intubation
US20040030330A1 (en) 2002-04-18 2004-02-12 Brassell James L. Electrosurgery systems
US20030208206A1 (en) 2002-05-01 2003-11-06 Norm Gitis Multiportal device and method for percutaneous surgery
US6830561B2 (en) 2002-05-08 2004-12-14 Scimed Life Systems, Inc. Catheter with protective sleeve
US7118576B2 (en) 2002-05-15 2006-10-10 Nevmet Corporation Multiportal device with linked cannulae and method for percutaneous surgery
US6949104B2 (en) 2002-05-31 2005-09-27 Jack Griffis Guide wire steering handle
WO2004002331A1 (en) 2002-06-29 2004-01-08 Hee-Young Lee Facial bone contouring device using hollowed rasp provided with non-plugging holes formed through cutting plane
US20050256423A1 (en) 2002-07-01 2005-11-17 Vaclav Kirsner Vaginal probe
US7239911B2 (en) 2002-07-08 2007-07-03 Siemens Aktiengesellschaft Method for localizing at least one focal lesion in a biological tissue section
US20040019359A1 (en) 2002-07-24 2004-01-29 Worley Seth J. Telescopic introducer with a compound curvature for inducing alignment and method of using the same
US20040059247A1 (en) 2002-09-04 2004-03-25 Urmey William F. Positioning system for a nerve stimulator needle
US20060058732A1 (en) 2002-09-27 2006-03-16 Harp Richard J Pump system
US7666186B2 (en) 2002-09-27 2010-02-23 Surgitech, Llc Surgical system with a blade
US20060206117A1 (en) 2002-09-27 2006-09-14 Harp Richard J Surgical system with a blade
US20060200153A1 (en) 2002-09-27 2006-09-07 Harp Richard J Surgical assembly for tissue removal
WO2004028351A2 (en) 2002-09-27 2004-04-08 Surgifile, Inc. Shielded reciprocating surgical file
US20040122459A1 (en) 2002-09-27 2004-06-24 Harp Richard J. Shielded reciprocating surgical file
WO2006047598A1 (en) 2002-09-27 2006-05-04 Surgifile, Inc. Surgical file system
US20060200155A1 (en) 2002-09-27 2006-09-07 Harp Richard J Surgical file instrument
US20060079919A1 (en) 2002-09-27 2006-04-13 Harp Richard J Drive apparatus
US20060161189A1 (en) 2002-09-27 2006-07-20 Harp Richard J Surgical file system with a visualization instrument
US20060200154A1 (en) 2002-09-27 2006-09-07 Harp Richard J Surgical file system with fluid system
US6907884B2 (en) 2002-09-30 2005-06-21 Depay Acromed, Inc. Method of straddling an intraosseous nerve
US20040067000A1 (en) 2002-10-07 2004-04-08 Bates Kenneth N. Systems and methods for minimally-invasive optical-acoustic imaging
US20040106940A1 (en) 2002-11-08 2004-06-03 Shaolian Samuel M. Transpedicular intervertebral disk access methods and devices
US7641658B2 (en) 2002-11-08 2010-01-05 Warsaw Orthopedic, Inc. Transpedicular intervertebral disk access methods and devices
WO2004043272A1 (en) 2002-11-14 2004-05-27 Sydney West Area Health Service An intramural needle-tipped surgical device
US7047084B2 (en) 2002-11-20 2006-05-16 Advanced Neuromodulation Systems, Inc. Apparatus for directionally stimulating nerve tissue
US20040098074A1 (en) 2002-11-20 2004-05-20 Erickson John H. Apparatus for directionally stimulating nerve tissue
US7166081B2 (en) 2002-11-22 2007-01-23 Mckinley Laurence M Method for locating, measuring, and evaluating the enlargement of a foramen
US20040102721A1 (en) 2002-11-22 2004-05-27 Mckinley Laurence M. System, method and apparatus for locating, measuring and evaluating the enlargement of a foramen
US7236832B2 (en) 2002-12-09 2007-06-26 Val-Chum, Societe En Commandite Neuromuscular monitoring using phonomyography
US7010352B2 (en) 2002-12-11 2006-03-07 The Mcw Research Foundation, Inc. Transcutaneous electrical nerve locator
US20040127893A1 (en) 2002-12-13 2004-07-01 Arthrocare Corporation Methods for visualizing and treating intervertebral discs
US20040116977A1 (en) 2002-12-13 2004-06-17 Finch Philip M. System and method for electrical stimulation of the intervertebral disc
WO2004056267A1 (en) 2002-12-20 2004-07-08 Baylis Medical Company Inc. Nerve proximity method and device
US20040122482A1 (en) 2002-12-20 2004-06-24 James Tung Nerve proximity method and device
US20070016097A1 (en) 2003-01-15 2007-01-18 Nuvasive, Inc. System and methods for determining nerve direction to a surgical instrument
US20040143280A1 (en) 2003-01-17 2004-07-22 Loubert Suddaby Flexible wire transection the transverse carpal ligament
US7216001B2 (en) 2003-01-22 2007-05-08 Medtronic Xomed, Inc. Apparatus for intraoperative neural monitoring
WO2004078066A2 (en) 2003-03-03 2004-09-16 Sinus Rhythm Technologies, Inc. Primary examiner
WO2004080316A1 (en) 2003-03-13 2004-09-23 Sdgi Holdings, Inc. Vertebral endplate preparation tool kit
US20040199166A1 (en) 2003-03-18 2004-10-07 Reinhold Schmieding ACL reconstruction technique using retrodrill
US20060089650A1 (en) 2003-04-11 2006-04-27 Martin Nolde Rasp attachment for a motor-driven surgical hand-held device
WO2004096080A2 (en) 2003-04-25 2004-11-11 Vertelink Corporation System and method for minimally invasive posterior fixation
US20040225233A1 (en) * 2003-05-09 2004-11-11 Frankowski Brian J. Magnetic guidewires
US20090143829A1 (en) 2003-05-16 2009-06-04 Zimmer Spine, Inc. Access device for minimally invasive surgery
US6999820B2 (en) 2003-05-29 2006-02-14 Advanced Neuromodulation Systems, Inc. Winged electrode body for spinal cord stimulation
US7107104B2 (en) 2003-05-30 2006-09-12 Medtronic, Inc. Implantable cortical neural lead and method
US20040260358A1 (en) 2003-06-17 2004-12-23 Robin Vaughan Triggered electromyographic test device and methods of use thereof
WO2005009300A1 (en) 2003-07-24 2005-02-03 Byung-Kwan Choi Prosthesis for vertebra
US7494473B2 (en) 2003-07-30 2009-02-24 Intact Medical Corp. Electrical apparatus and system with improved tissue capture component
US20060025703A1 (en) 2003-08-05 2006-02-02 Nuvasive, Inc. System and methods for performing dynamic pedicle integrity assessments
US20050033393A1 (en) 2003-08-08 2005-02-10 Advanced Neuromodulation Systems, Inc. Apparatus and method for implanting an electrical stimulation system and a paddle style electrical stimulation lead
US6923813B2 (en) 2003-09-03 2005-08-02 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US7207949B2 (en) 2003-09-25 2007-04-24 Nuvasive, Inc. Surgical access system and related methods
US20050149035A1 (en) 2003-10-17 2005-07-07 Nuvasive, Inc. Surgical access system and related methods
US20050149034A1 (en) 2003-10-23 2005-07-07 Assell Robert L. Method and apparatus for manipulating material in the spine
US20050171587A1 (en) 2003-11-25 2005-08-04 Advanced Neuromodulation Systems, Inc. Directional stimulation lead and orientation system
US20070166345A1 (en) 2003-11-28 2007-07-19 Dusan Pavcnik Vascular occlusion methods, systems and devices
WO2005057467A2 (en) 2003-12-02 2005-06-23 Subqiview Inc. Tissue characterization using an eddy-current probe
US20080197024A1 (en) 2003-12-05 2008-08-21 Dexcom, Inc. Analyte sensor
US20090138056A1 (en) 2003-12-16 2009-05-28 Depuy Spine, Inc. Methods and devices for minimally invasive spinal fixation element placement
US20050149154A1 (en) 2003-12-29 2005-07-07 Biocontrol Medical Bcm Ltd. Nerve-branch-specific action-potential activation,inhibition, and monitoring
US20080125709A1 (en) 2003-12-31 2008-05-29 Gregory Waimong Chang Needle catheter
US20050283204A1 (en) 2004-01-30 2005-12-22 Felix Buhlmann Automated adaptive muscle stimulation method and apparatus
US20060030854A1 (en) 2004-02-02 2006-02-09 Haines Timothy G Methods and apparatus for wireplasty bone resection
WO2005077282A1 (en) 2004-02-11 2005-08-25 Spinevision Exploration device for monitoring the penetration of an instrument into an anatomical structure
US20060064101A1 (en) 2004-02-12 2006-03-23 Arthrocare Corporation Bone access system
US20050187537A1 (en) 2004-02-19 2005-08-25 Loeb Marvin P. Angular deflection apparatus for use in confined spaces and method of use
US20080288005A1 (en) 2004-02-27 2008-11-20 Jackson Roger P Orthopedic implant rod reduction tool set and method
US20050197661A1 (en) 2004-03-03 2005-09-08 Scimed Life Systems, Inc. Tissue removal probe with sliding burr in cutting window
US20050209622A1 (en) 2004-03-03 2005-09-22 Scimed Life Systems, Inc. Tissue removal probe with irrigation and aspiration ports
US20050209610A1 (en) 2004-03-03 2005-09-22 Scimed Life Systems, Inc. Radially adjustable tissue removal device
US20050209617A1 (en) 2004-03-05 2005-09-22 Paul Koven Valvulotome
US20050203599A1 (en) 2004-03-12 2005-09-15 Scimed Life Systems, Inc. Modular stimulation lead network
WO2005089433A2 (en) 2004-03-18 2005-09-29 Onset Medical, Inc. Expandable medical access device
US20050216023A1 (en) 2004-03-29 2005-09-29 Luke Aram Method and apparatus for arthroscopic bone preparation
US20050222598A1 (en) 2004-04-05 2005-10-06 Manoa Medical, Inc., A Delaware Corporation Tissue cutting device
US20050234425A1 (en) 2004-04-16 2005-10-20 Innospine, Inc. Spinal diagnostic methods and apparatus
US7507218B2 (en) 2004-04-26 2009-03-24 Gyrus Acmi, Inc. Stent with flexible elements
US20050261692A1 (en) 2004-05-21 2005-11-24 Scimed Life Systems, Inc. Articulating tissue removal probe and methods of using the same
US7087053B2 (en) 2004-05-27 2006-08-08 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter with bifurcated, collapsible tip for sensing and ablating
US20050277942A1 (en) 2004-05-27 2005-12-15 Kullas Karen E Method and apparatus for delivering a prosthetic fabric into a patient
US20060004369A1 (en) 2004-06-17 2006-01-05 Scimed Life Systems, Inc. Slidable sheaths for tissue removal devices
US20050283148A1 (en) 2004-06-17 2005-12-22 Janssen William M Ablation apparatus and system to limit nerve conduction
WO2006009705A2 (en) 2004-06-17 2006-01-26 Jnj Technology Holdings, L.L.C. Ablation apparatus and system to limit nerve conduction
EP1611851A1 (en) 2004-06-30 2006-01-04 Thompson Surgical Instruments, Inc. Elongateable surgical port and dilator
US20060025797A1 (en) 2004-07-15 2006-02-02 James Lock Cannula for in utero surgery
US20060184175A1 (en) 2004-07-29 2006-08-17 X-Sten, Inc. Spinal ligament modification devices
US20060036272A1 (en) 2004-07-29 2006-02-16 X-Sten, Inc. Spinal ligament modification
US20060235451A1 (en) 2004-07-29 2006-10-19 X-Sten Ligament Decompression Tool with Tissue Engaging Device
US20060264994A1 (en) 2004-07-29 2006-11-23 X-Sten Spinal Decompression Method Using Tissue Retraction
US20060025702A1 (en) 2004-07-29 2006-02-02 Medtronic Xomed, Inc. Stimulator handpiece for an evoked potential monitoring system
US20060206115A1 (en) 2004-07-29 2006-09-14 X-Sten Ligament decompression kit with contrast
US20060036271A1 (en) 2004-07-29 2006-02-16 X-Sten, Inc. Spinal ligament modification devices
WO2006015302A1 (en) 2004-07-29 2006-02-09 X-Sten, Corp. Spinal ligament modification devices
US20070198019A1 (en) 2004-07-29 2007-08-23 X-Sten Corp. Spinal ligament modification devices
US20060235452A1 (en) 2004-07-29 2006-10-19 X-Sten Ligament Decompression Tool with Tissue Removal Device
US20060036211A1 (en) 2004-07-29 2006-02-16 X-Sten, Inc. Spinal ligament modification kit
WO2006017507A2 (en) 2004-08-03 2006-02-16 Triage Medical Telescopic percutaneous tissue dilation systems and related methods
US7503920B2 (en) 2004-08-11 2009-03-17 Tzony Siegal Spinal surgery system and method
US7337006B2 (en) 2004-09-08 2008-02-26 Spinal Modulation, Inc. Methods and systems for modulating neural tissue
US7337005B2 (en) 2004-09-08 2008-02-26 Spinal Modulations, Inc. Methods for stimulating a nerve root ganglion
WO2006039279A2 (en) 2004-09-29 2006-04-13 Synthes (U.S.A) Less invasive surgical system and methods
WO2006042206A2 (en) 2004-10-06 2006-04-20 Nuvasive, Inc. Systems and methods for direct restoration of foraminal volume
US20090018610A1 (en) 2004-10-07 2009-01-15 James Gharib System and methods for assessing the neuromuscular pathway prior to nerve testing
US20060095059A1 (en) 2004-10-15 2006-05-04 Baxano, Inc. Devices and methods for tissue modification
US20110224710A1 (en) 2004-10-15 2011-09-15 Bleich Jeffery L Methods, systems and devices for carpal tunnel release
US7938830B2 (en) 2004-10-15 2011-05-10 Baxano, Inc. Powered tissue modification devices and methods
US20110160731A1 (en) 2004-10-15 2011-06-30 Bleich Jeffery L Devices and methods for tissue access
US20060089633A1 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue access
US20120016368A1 (en) 2004-10-15 2012-01-19 Bleich Jeffery L Flexible tissue rasp
US20110190772A1 (en) 2004-10-15 2011-08-04 Vahid Saadat Powered tissue modification devices and methods
US20110224709A1 (en) 2004-10-15 2011-09-15 Bleich Jeffery L Methods, systems and devices for carpal tunnel release
US20100331883A1 (en) 2004-10-15 2010-12-30 Schmitz Gregory P Access and tissue modification systems and methods
US20110060314A1 (en) 2004-10-15 2011-03-10 Wallace Michael P Devices and methods for treating tissue
US20060122458A1 (en) 2004-10-15 2006-06-08 Baxano, Inc. Devices and methods for tissue access
US7918849B2 (en) 2004-10-15 2011-04-05 Baxano, Inc. Devices and methods for tissue access
US20060100651A1 (en) 2004-10-15 2006-05-11 Baxano, Inc. Devices and methods for tissue access
US20060135882A1 (en) 2004-10-15 2006-06-22 Baxano, Inc. Devices and methods for selective surgical removal of tissue
US20060094976A1 (en) 2004-10-15 2006-05-04 Baxano, Inc. Devices and methods for selective surgical removal of tissue
US20060095028A1 (en) 2004-10-15 2006-05-04 Baxano, Inc. Devices and methods for tissue access
US20070213735A1 (en) 2004-10-15 2007-09-13 Vahid Saadat Powered tissue modification devices and methods
US20110004207A1 (en) 2004-10-15 2011-01-06 Baxano, Inc. Flexible Neural Localization Devices and Methods
US20060089609A1 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue modification
US20060089640A1 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue modification
US20070123888A1 (en) 2004-10-15 2007-05-31 Baxano, Inc. Flexible tissue rasp
US20070213733A1 (en) 2004-10-15 2007-09-13 Bleich Jeffery L Mechanical tissue modification devices and methods
US20100094231A1 (en) 2004-10-15 2010-04-15 Bleich Jeffery L Devices and methods for tissue modification
WO2006044727A2 (en) 2004-10-15 2006-04-27 Baxano, Inc. Devices and methods for tissue removal
US20060085048A1 (en) 2004-10-20 2006-04-20 Nervonix, Inc. Algorithms for an active electrode, bioimpedance-based tissue discrimination system
US20060122620A1 (en) 2004-10-20 2006-06-08 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for stabilizing the motion or adjusting the position of the spine
US20060085049A1 (en) 2004-10-20 2006-04-20 Nervonix, Inc. Active electrode, bio-impedance based, tissue discrimination system and methods of use
US20060089688A1 (en) 2004-10-25 2006-04-27 Dorin Panescu Method and apparatus to reduce wrinkles through application of radio frequency energy to nerves
WO2006058079A3 (en) 2004-11-22 2006-11-30 Endius Inc Expandable device for providing access to the spine
WO2006058195A2 (en) 2004-11-23 2006-06-01 Pneumrx, Inc. Steerable device for accessing a target site and methods
US20060149278A1 (en) 2004-11-24 2006-07-06 Abdou Amy M Devices and methods for inter-vertebral orthopedic device placement
WO2006062555A2 (en) 2004-12-06 2006-06-15 Mckinley Laurence M Improved surgical rongeur
US20100057087A1 (en) 2004-12-20 2010-03-04 Spinascope, Inc. Surgical instrument for orthopedic surgery
US20060173374A1 (en) 2005-01-31 2006-08-03 Neubardt Seth L Electrically insulated surgical probing tool
US20090105604A1 (en) 2005-02-02 2009-04-23 Nuvasive, Inc. System and Methods for Monitoring During Anterior Surgery
US20090177112A1 (en) 2005-02-02 2009-07-09 James Gharib System and Methods for Performing Neurophysiologic Assessments During Spine Surgery
US20060195107A1 (en) 2005-02-02 2006-08-31 Jones Bryan S Ultrasonic cutting device
US20060241648A1 (en) * 2005-02-04 2006-10-26 Bleich Jeffery L Methods and apparatus for tissue modification
WO2006086241A2 (en) 2005-02-04 2006-08-17 Nuvasive, Inc. Methods and apparatus for treating spinal stenosis
WO2006099285A2 (en) 2005-03-11 2006-09-21 The Board Of Trustees Of The Leland Stanford Junior University Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment
US20060206118A1 (en) 2005-03-11 2006-09-14 Kim Daniel H Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment
US20060206178A1 (en) 2005-03-11 2006-09-14 Kim Daniel H Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment
WO2006102085A2 (en) 2005-03-18 2006-09-28 Alphaspine, Inc. Less invasive access port system and method for using the same
US20060276802A1 (en) 2005-03-29 2006-12-07 Edward Vresilovic Method and apparatus for implanting a hydrogel prosthesis for a nucleus pulposus
US20060224060A1 (en) 2005-03-31 2006-10-05 Garell P C Neural probe array
US20070016185A1 (en) 2005-04-29 2007-01-18 Tullis Philip J Medical Bipolar Electrode Assembly With A Cannula Having A Bipolar Active Tip And A Separate Supply Electrode And Medical Monopolar Electrode Assembly With A Cannula Having A Monopolar Active Tip And A Separate Temperature-Transducer Post
US20070055262A1 (en) 2005-05-10 2007-03-08 Mani., Inc. Surgical saw
US20060258951A1 (en) 2005-05-16 2006-11-16 Baxano, Inc. Spinal Access and Neural Localization
US20060264952A1 (en) 2005-05-18 2006-11-23 Nelson Charles L Methods of Using Minimally Invasive Actuable Bone Fixation Devices
US20060276720A1 (en) 2005-06-03 2006-12-07 Mcginnis William C Method of using dermatomal somatosensory evoked potentials in real-time for surgical and clinical management
US20060276836A1 (en) 2005-06-07 2006-12-07 Bergin Patrick J Hemostatic wire guided bandage and method of use
US20070073356A1 (en) 2005-06-09 2007-03-29 Medtronic, Inc. Combination therapy including peripheral nerve field stimulation
WO2007008709A2 (en) 2005-07-12 2007-01-18 Kyphon Inc. Measurement instrument for percutaneous surgery
US20070027464A1 (en) 2005-07-29 2007-02-01 X-Sten, Corp. Device for resecting spinal tissue
US20070027514A1 (en) 2005-07-29 2007-02-01 Medtronic, Inc. Electrical stimulation lead with conformable array of electrodes
US20070055215A1 (en) 2005-07-29 2007-03-08 X-Sten Corp. Percutaneous Tissue Excision Devices and Methods
US20070055263A1 (en) 2005-07-29 2007-03-08 X-Sten Corp. Tools for Percutaneous Spinal Ligament Decompression and Device for Supporting Same
WO2007021588A1 (en) 2005-08-12 2007-02-22 Stryker Spine System and method for spinal implant placement
WO2007022194A2 (en) 2005-08-16 2007-02-22 Benvenue Medical, Inc. Spinal tissue distraction devices
US20070123766A1 (en) 2005-09-29 2007-05-31 Whalen John J Iii Microelectrode systems for neuro-stimulation and neuro-sensing and microchip packaging and related methods
US20070225703A1 (en) 2005-10-15 2007-09-27 Baxano, Inc. Flexible Tissue Removal Devices and Methods
US7887538B2 (en) 2005-10-15 2011-02-15 Baxano, Inc. Methods and apparatus for tissue modification
US20070106219A1 (en) 2005-10-31 2007-05-10 Andreas Grabinsky Cleveland round tip (CRT) needle
US20070123890A1 (en) 2005-11-04 2007-05-31 X-Sten, Corp. Tissue retrieval devices and methods
US20070162061A1 (en) 2005-11-04 2007-07-12 X-Sten, Corp. Tissue excision devices and methods
WO2007059343A2 (en) 2005-11-16 2007-05-24 Boston Scientific Neuromodulation Corporation Implantable stimulator configured to be implanted within a patient in a pre-determined orientation
US20070255162A1 (en) 2005-11-18 2007-11-01 Marwan Abboud Bioimpedance measurement system and method
US20070162044A1 (en) 2005-11-23 2007-07-12 Trinity Orthopedics Percutaneous transpedicular access, fusion, discectomy, and stabilization system and method
WO2007067632A2 (en) 2005-12-06 2007-06-14 Epi-Sci, Llc Method and system for detecting electrophysiological changes in pre-cancerous and cancerous tissue and epithelium
US20070162062A1 (en) 2005-12-08 2007-07-12 Norton Britt K Reciprocating apparatus and methods for removal of intervertebral disc tissues
US20080319459A1 (en) 2005-12-23 2008-12-25 Azad Al-Najjar Laparoscopic Instrument
US7655026B2 (en) 2006-01-31 2010-02-02 Warsaw Orthopedic, Inc. Expandable spinal rods and methods of use
US20090182382A1 (en) 2006-02-07 2009-07-16 Warsaw Orthopedic, Inc. Surgical instruments and techniques for percutaneous placement of spinal stablization elements
US20070213583A1 (en) 2006-03-10 2007-09-13 Kim Daniel H Percutaneous access and visualization of the spine
US20070213584A1 (en) 2006-03-10 2007-09-13 Kim Daniel H Percutaneous access and visualization of the spine
US20070213734A1 (en) 2006-03-13 2007-09-13 Bleich Jeffery L Tissue modification barrier devices and methods
US20070270865A1 (en) 2006-04-05 2007-11-22 Uri Arnin Spinal reamer
US7617006B2 (en) 2006-04-28 2009-11-10 Medtronic, Inc. Medical electrical lead for spinal cord stimulation
US20070255369A1 (en) 2006-04-28 2007-11-01 Bonde Eric H Multi-electrode peripheral nerve evaluation lead and related system and method of use
US20070260252A1 (en) 2006-05-04 2007-11-08 Baxano, Inc. Tissue Removal with at Least Partially Flexible Devices
US20070276390A1 (en) 2006-05-09 2007-11-29 X-Sten, Inc. Ipsilateral Approach to Minimally Invasive Ligament Decompression Procedure
US20070276286A1 (en) 2006-05-27 2007-11-29 Craig James Miller Device for Tissue Diagnosis and Spatial Tissue Mapping
US20070282217A1 (en) 2006-06-01 2007-12-06 Mcginnis William J Methods & systems for intraoperatively monitoring nerve & muscle frequency latency and amplitude
US20070299403A1 (en) 2006-06-23 2007-12-27 Crowe John E Directional introducer
US20070299459A1 (en) 2006-06-26 2007-12-27 X-Sten Corp. Percutaneous Tissue Access Device
WO2008008898A2 (en) 2006-07-13 2008-01-17 Baxano, Inc. Spinal access and neural localization
US20080033465A1 (en) 2006-08-01 2008-02-07 Baxano, Inc. Multi-Wire Tissue Cutter
US20080051812A1 (en) 2006-08-01 2008-02-28 Baxano, Inc. Multi-Wire Tissue Cutter
US20080091227A1 (en) 2006-08-25 2008-04-17 Baxano, Inc. Surgical probe and method of making
US20110046613A1 (en) 2006-08-29 2011-02-24 Gregory Schmitz Tissue access guidewire system and method
US7857813B2 (en) 2006-08-29 2010-12-28 Baxano, Inc. Tissue access guidewire system and method
US20080086034A1 (en) 2006-08-29 2008-04-10 Baxano, Inc. Tissue Access Guidewire System and Method
US20080086114A1 (en) 2006-08-29 2008-04-10 Baxano, Inc. Tissue Access Guidewire System and Method
US20080058874A1 (en) 2006-09-01 2008-03-06 Randy Westlund Method and apparatus for optimizing vagal nerve stimulation using laryngeal activity
US20080161809A1 (en) 2006-10-03 2008-07-03 Baxano, Inc. Articulating Tissue Cutting Device
US20080161810A1 (en) 2006-10-18 2008-07-03 Warsaw Orthopedic, Inc. Guide and Cutter for Contouring Facet Joints and Methods of Use
US20080097465A1 (en) 2006-10-21 2008-04-24 Aaron Rollins Guidewire Manipulation Device
US20080103504A1 (en) 2006-10-30 2008-05-01 Schmitz Gregory P Percutaneous spinal stenosis treatment
US20080119711A1 (en) 2006-11-16 2008-05-22 Suwas Nikumb Neurological probe and method of using same
US20080140169A1 (en) 2006-12-06 2008-06-12 Spinal Modulation, Inc. Delivery devices, systems and methods for stimulating nerve tissue on multiple spinal levels
US20080140153A1 (en) 2006-12-06 2008-06-12 Spinal Modulation, Inc. Expandable stimulation leads and methods of use
US20080147084A1 (en) 2006-12-07 2008-06-19 Baxano, Inc. Tissue removal devices and methods
US20080221586A1 (en) 2007-02-09 2008-09-11 Alphatec Spine, Inc. Curviliner spinal access method and device
US20080221383A1 (en) 2007-02-12 2008-09-11 Vertos Medical, Inc. Tissue excision devices and methods
US20080200912A1 (en) 2007-02-15 2008-08-21 Long Gary L Electroporation ablation apparatus, system, and method
US7648521B2 (en) 2007-03-15 2010-01-19 Zimmer Spine, Inc. System and method for minimally invasive spinal surgery
US20090054804A1 (en) 2007-04-03 2009-02-26 Nuvasive Inc. Neurophysiologic monitoring system
WO2009012265A2 (en) 2007-07-16 2009-01-22 Zimmer Spine, Inc. Surgical site access system and deployment device for same
WO2009018220A1 (en) 2007-07-31 2009-02-05 Zimmer Spine, Inc. Method for stabilizing a facet joint
WO2009021116A2 (en) 2007-08-07 2009-02-12 Synthes (U.S.A.) Dynamic cable system
US20090054941A1 (en) 2007-08-20 2009-02-26 Medtronic, Inc. Stimulation field management
US20090054936A1 (en) 2007-08-20 2009-02-26 Medtronic, Inc. Implantable medical lead with biased electrode
US20090216284A1 (en) 2007-08-27 2009-08-27 Singfatt Chin Balloon cannula system for accessing and visualizing spine and related methods
US20090062872A1 (en) 2007-08-27 2009-03-05 Singfatt Chin Balloon cannula system for accessing and visualizing spine and related methods
US20090062871A1 (en) 2007-08-27 2009-03-05 Singfatt Chin Balloon cannula system for accessing and visualizing spine and related methods
US20110196257A1 (en) 2007-09-06 2011-08-11 Schmitz Gregory P Method, system and apparatus for neural localization
WO2009036156A1 (en) 2007-09-14 2009-03-19 Synthes Usa, Llc Interspinous spacer
WO2009046046A1 (en) 2007-10-01 2009-04-09 Warsaw Orthopedic, Inc. Flexible members for correcting spinal deformities
WO2009058566A1 (en) 2007-10-29 2009-05-07 Zimmer Spine, Inc. Minimally invasive interbody device and method
US20090118709A1 (en) 2007-11-06 2009-05-07 Vertos Medical, Inc. A Delaware Corporation Tissue Excision Tool, Kits and Methods of Using the Same
US20090124934A1 (en) 2007-11-09 2009-05-14 Abbott Laboratories Guidewire torque device
US20090143807A1 (en) 2007-12-03 2009-06-04 Vertos Medical, Inc., A Delaware Corporation Percutaneous Devices for Separating Tissue, Kits and Methods of Using the Same
US20090177144A1 (en) 2007-12-17 2009-07-09 California Institute Of Technology Micromachined neural probes
WO2009151926A2 (en) 2008-05-23 2009-12-17 Spine View, Inc. Method and devices for treating spinal stenosis
US20100274250A1 (en) 2008-07-01 2010-10-28 Wallace Michael P Tissue modification devices and methods
US20110112539A1 (en) 2008-07-14 2011-05-12 Wallace Michael P Tissue modification devices
US20100331900A1 (en) 2009-06-25 2010-12-30 Baxano, Inc. Surgical tools for treatment of spinal stenosis

Non-Patent Citations (89)

* Cited by examiner, † Cited by third party
Title
Abdel-Wanis et al., "Tumor growth potential after tumoral and instrumental contamination: an in-vivo comparative study of T-saw, Gigli saw, and scalpel," Journal of orthopaedic science, 2001, vol. 6, 424R429.
Arcenio et al.; U.S. Appl. No. 12/980,165 entitled "Systems and Methods for Performing Spinal Fusion", filed Dec. 28, 2010.
Barer Malvin, "Instrument to Enhance Passage of the Gigli Saw," Journal of Pediatric Orthopedics, Raven Press, New York, 1984, 4:762-763.
Baumgart et al., "Indikation and Technik der Knochendurchtrennung," Der Chirurg, 1998, vol. 69:1188-1196. (in German with Eng Summary).
Bleich et al.; U.S. Appl. No. 12/352,978 entitled "Multiple pathways for spinal nerve rood decompression from a single access point," filed Jan. 13, 2009.
Bleich et al.; U.S. Appl. No. 12/428,369 entitled "Devices and methods for tissue modification," filed Apr. 22, 2009.
Bleich et al.; U.S. Appl. No. 12/504,545 entitled "Spinal access and neural localization," filed Jul. 16, 2009.
Bleich et al.; U.S. Appl. No. 12/984,162 entitled "Devices and Methods for Tissue Access", filed Jan. 4, 2011.
Bleich et al.; U.S. Appl. No. 13/112,886 entitled "Methods, Systems and Devices for Carpal Tunnel Release", filed May 20, 2011.
Bleich et al.; U.S. Appl. No. 13/112,918 entitled "Methods, Systems and Devices for Carpal Tunnel Release", filed May 20, 2011.
Bleich et al.; U.S. Appl. No. 13/312,272 entitled "Multiple Pathways for Spinal Nerve Root Decompression From a Single Access Point," filed Dec. 6, 2011.
Bleich, et al.; U.S. Appl. No. 12/140,201 entitled "Devices and methods for measuring the space around a nerve root," filed Jun. 16, 2008.
Bleich, Jeffrey; U.S. Appl. No. 12/357,289 entitled "Devices and methods for selective surgical removal of tissue, "filed Jan. 21, 2009.
Bohinski et al., "Novel use of a threadwire saw for high sacral amputation," Journal of neurosurgery: Spine, 2005, vol. 3, 71R78.
Brunori et al., "Celebrating the centennial (1894-1994): Leonardo Gigli and his wire saw," J. Neurosurg, 1995, 82:1086-1090.
Burrows, Harold, "Surgical instruments and appliances used in operations," Faber and Faber, London, 1937, total pp. 4.
Codman Laminectomy Shaver (a Johnson & Johnson company www.codman.com) catalogue, pp. 416-431, [online] Retrieved from the internet: . First accessedOct. 24, 2006.
Codman Laminectomy Shaver (a Johnson & Johnson company www.codman.com) catalogue, pp. 416-431, [online] Retrieved from the internet: <URL: http:llwww.codman.com/PDFs/Catalog—04—R.pdf>. First accessedOct. 24, 2006.
Dammann, Gordon, Pictorial Encyclopedia of Civil War Medical Instruments and Equipment, Pictorial Histories Publishing Company, Missoula, Montana, 1983, Total pp. 2.
Edwards et al; "T-Saw Laminoplasty for the Management of Cervical Spondylotic Myelopathy," Spine, Lippincott Williams & Wilkins, Inc., 2000, vol. 25 (14): 1788R1794.
Ellman Int. Disc-FX System Accessories K052241 [online] Retrieved from the Internet: . Feb. 27, 2006.
Ellman Int. Disc-FX System Accessories K052241 [online] Retrieved from the Internet: <URL: http://www.ellman.com/ medical/ >. Feb. 27, 2006.
Eralp et al., "A comparison of two osteotomy techniques for tibial lengthening," Archives of orthopaedic and trauma surgery, 2004, vol. 124:298R300.
Fessler Richard G, "Minimally Invasive Microendoscopic Decompressive Laminotomy for Lumbar Stenosis," American Association of Neurological Surgeons, 2006, Online CME course, [Retrieved on Jun. 29, 2006 from the internet http://www.aans.emedtrain.com/lumbar-stenosis/lumbarStenosis.swf.
Fujita et al., "Chordoma in the Cervical Spine Managed with En Bloc Excision," Spine, Lippincott Williams & Wilkins, Inc., 1999, 24 (17), 1848-1851.
Garabedian et al.; U.S. Appl. No. 12/824,043; entitled "Surgical Tools for Treatment of Spinal Stenosis"; filed Jun. 25, 2010.
Goel, Atul, "Neurosurgical forum, Supraorbital Craniotomy," Journal of Neurosurgery, 1994, vol. 81, 642-643.
Gore Smoother User Manual, W. L. Gore & Associates, Inc. Flagstaff, AZ, Dec. 1999,Total pp. 3.
Hara et al., "En Bloc Laminoplasty Performed with Threadwire Saw: Technical Note," Neurosurgery, Jan. 2001, vol. 48, No. 1, pp. 235-239.
Hata et al; "A less invasive surgery for rotator cuff tear: Mini-open repair," Journal of Shoulder and Elbow Surgery, 2001, vol. 10 No. 1, 11-16.
Honl et al; "The Use of Water-Jetting Technology in Prostheses Revision Surgery R First Results of Parameter Studies on Bone and Bone Cement," J. Biomed Mater Res (Applied Biomaterials), John Wiley & Sons, Inc, 2000, 53, 6: 781-790.
Integra Ruggles TM Kerrison Rongeurs [online] Retrieved from the internet: . First accessedOct. 24, 2006.
Integra Ruggles TM Kerrison Rongeurs [online] Retrieved from the internet: <URL: http://www.integra-ls.com/products!? product=22>. First accessedOct. 24, 2006.
Jun, Byung-Yoon, "Posterior Lumbar Interbody Fusion With Restoration of Lamina and Facet Fusion," Spine, Lippincott Williams & Wilkins, Inc., 2000, vol. 25 No. 8, 917R922.
Kawahara et al., "Recapping T-Saw Laminoplasty for Spinal Cord Tumors," Spine, 1999, vol. 24 No. 13, pp. 1363-1370.
Martin-Benlloch et al., "Expansive Laminoplasty as a Method for Managing Cervical Multilevel Spondylotic Myelopathy," Spine, Lippincott Williams & Wilkins, Inc., 2003, vol. 28 No. 7, 680R684.
Miyamoto et al., "Kyphectomy Using a Surgical Threadwire (T-saw) for Kyphotic Deformity in a Child With Myelomeningocele," Spine, Lippincott Williams & Wilkins, Inc., 2003, vol. 28 No. 10, E187RE190.
Mopec Bone-Cutting tool, Product brochure, Total pp. 4. First accessed Dec. 15, 2005.
Nakagiri et al., "Thoracoscopic Rib Resection Using a Gigli Saw," The Annals of Thoracic Surgery, 2005, vol. 80, 755R756.
Ohta et al., "Superimposed Mechanomygraphic Response at Different Contraction Intensity in Medial Gastrocnemius and Soleus Muscles," International Journal of Sport and Health Science: vol. 5, 63-70, 2007.
Osaka et al., "Clinical significance of a wide excision policy for sacrococcygeal chordoma," J Cancer Res Clin Oncol, 2005, Total pp. 6.
Paktiss et al., "Afghan Percutaneous Osteotomy," Journal of Pediatric Orthopaedics, Raven Press Ltd, New York, 1993, vol. 13 No. 4, 531-533.
Paley et al., "Percutaneous Osteotomies," Orthopedic Clinics of North America, 1991, vol. 22 No. 4, 613-624.
Pancoast, Joseph, "A Treatise on Operative Surgery," Carey and Hart, Philadelphia, 1844, Total pp. 11.
Park et al; "Cases of the Excision of Carious Joints," John Scrymgeour, Glasgow, 1806, Total pp. 6.
Peavy et al., "Comparison of Cortical Bone Ablations by Using Infrared Laser Wavelengths 2.9 to 9.2 mum, Lasers in Surgery and Medicine," 1999, vol. 26, 421R434.
Peavy et al., "Comparison of Cortical Bone Ablations by Using Infrared Laser Wavelengths 2.9 to 9.2 μm, Lasers in Surgery and Medicine," 1999, vol. 26, 421R434.
Peltier, Leonard Orthopedics: A History and Iconography, Norman Publishing, San Francisco, 1993, Total pp. 3.
Reckling Frederick, "Modified Stethoscope Earpiece Makes Excellent Gigli Saw Guide," J Bone and Joint Surgery Am, Dec. 1972, 54-A(8), 1787-1788.
Rutkow, Ira, "Surgery An Illustrated History," Mosby'Year Book, Inc., St. Louis, 1993, Total pp. 4.
Saadat et al.; U.S. Appl. No. 13/078,376 entitled "Powered Tissue Modification Devices and Methods", filed Apr. 1, 2011.
Schmitz et al.; U.S. Appl. No. 12/170,392 entitled "Spinal access system and method," filed Jul. 9, 2008.
Schmitz et al.; U.S. Appl. No. 12/324,147 entitled "Tissue modification devices," filed Nov. 26, 2008.
Schmitz et al.; U.S. Appl. No. 12/352,385 entitled "Devices, methods and systems for neural localization," filed Jan. 12, 2009.
Schmitz et al.; U.S. Appl. No. 12/496,094 entitled "Access and tissue modification systems and methods," filed Jul. 1, 2009.
Schmitz et al.; U.S. Appl. No. 12/816,729 entitled Access and Tissue Modification Systems and Methods, filed Jun. 16, 2010.
Schmitz et al.; U.S. Appl. No. 12/917,253; entitled "Tissue Access Guidewire System and Method"; filed Nov. 1, 2010.
Schmitz et al.; U.S. Appl. No. 13/090,944 entitled "Method, System and Apparatus for Neural Localization", filed Apr. 20, 2011.
Schmitz et al.; U.S. Appl. No. 13/232,882 entitled "Tissue Modification Devices," filed Sep. 14, 2011.
Schmitz et al.; U.S. Appl. No. 13/267,683 entitled "Flexible Tissue Removal Devices and Methods," filed Oct. 6, 2011.
Schmitz et al; U.S. Appl. No. 12/060,229 entitled "Method, system, and apparatus for neural localization," filed Mar. 31, 2008.
Schwieger et al., "Abrasive Water Jet Cutting as a New Procedure for Cutting Cancellous Bone'In Vitro Testing in Comparison with the Oscillating Saw," Wiley Interscience, www.interscience,wiley.com, Sep. 20, 2004, 223-228.
Schwieger et al., "Abrasive Water Jet Cutting as a New Procedure for Cutting Cancellous Bone-In Vitro Testing in Comparison with the Oscillating Saw," Wiley Interscience, www.interscience,wiley.com, Sep. 20, 2004, 223-228.
Sen, Cengiz, Tibia proksimalinde Gigli testeresi ile yapilanperk�tan osteotominin g�venilirligi: Kadavra calismasi, Acta orthopaedica et traumatologica turcica, 2002, vol. 36, 136-140; (in Russian w/ Eng Summary).
Sen, Cengiz, Tibia proksimalinde Gigli testeresi ile yapilanperkütan osteotominin güvenilirligi: Kadavra calismasi, Acta orthopaedica et traumatologica turcica, 2002, vol. 36, 136-140; (in Russian w/ Eng Summary).
Shiraishi et al., "Results of Skip Laminectomy-Minimum 2-Year Follow-up Study Compared With Open-Door Laminoplasty," Spine, Lippincott Williams & Wilkins, Inc., 2003, vol. 28 No. 24, 2667-2672.
Shiraishi T., "A new technique for exposure of the cervical spine laminae," Journal of neurosurgery. Spine, 2002, vol. 96(1), 122-126.
Shiraishi T., Skip laminectomy-a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report, Spine, 2002, vol. 2(2), 108-115.
Skippen et al., "The Chain Saw R A Scottish Invention," Scottish Medical Journal, 2004, vol. 49(2), 72-75.
Stevens et al., "Calvarial Bone Graft Harvest Using the Gigli Saw," Journal of Oral and Maxillofacial Surgery, 1998, vol. 56, 798-799.
Sun et al.; U.S. Appl. No. 13/340,363 entitled "Flexible Neural Localization Devices and Methods," filed Dec. 29, 2011.
Takada et al., "Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma," Spine, Lippincott Williams & Wilkins, Inc., 2003, vol. 28 No. 6, E114RE117.
Tomita et al., "Expansive Midline T-Saw Laminoplasty (Modified Spinour Process-Splitting) for the Management of Cervical Myelopathy," Spine, Lippincott Williams & Wilkins, Inc, 1998, 23(1), 32-37.
Tomita et al., "The Threadwire Saw: a New Device for Cutting Bone," The Journal of Bone and Joint Surgery, 1996, vol. 78, 1915-1917.
Tomita et al., "The Use of the T-Saw for Expansive Midline laminoplasty in the Treatment of Cervical Myelopathy," Orthopedics and Traumatology, No. 3, pp. 169-178, 2002.
Tomita et al., "Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis," Paraplegia, 1994, 32:36-46.
Tomita K. et al., "Total en bloc spondylectomy for solitary spinal metastases," International Orthopaedics (SICOT), 1994, 18: 291-298.
Truax, Charles, "The Mechanics of Surgery," Chicago, IL; 1899, Total pp. 3.
US Surgical Kerrison Spinal Rongeur K943116 [online] Retrieved from the internet: . Jul. 27, 1994.
US Surgical Kerrison Spinal Rongeur K943116 [online] Retrieved from the internet: <URL: http://www.ussurg.com/uss/index.html>. Jul. 27, 1994.
Wallace et al.; U.S. Appl. No. 12/724,315 entitled "Flexible Neural Localization Devices and Methods," filed Mar. 15, 2010.
Wallace et al.; U.S. Appl. No. 12/773,595 entitled "Tissue Modification Devices and Methods," filed May 4, 2010.
Wallace et al.; U.S. Appl. No. 12/911,537 entitled "Devices and Methods for Treating Tissue", filed Oct. 25, 2010.
Wallace et al.; U.S. Appl. No. 13/007,381 entitled "Tissue Modification Devices", filed Jan. 14, 2011.
Wallace et al.; U.S. Appl. No. 13/338,103 entitled "Tissue Modification Devices and Methods," filed Dec. 27, 2011.
Wallace et al.; U.S. Appl. No. 13/338,134 entitled "Surgical Tools for Treatment of Spinal Stenosis." filed Dec. 27, 2011.
Wilkins, Robert H, "Neurosurgical Classics," Johnson Reprint Corporation, New York, 1965, 377-382.
Zeppelin Laminectomy Rongeur K901372, [online] Retrieved from the internet: . Oct. 24, 2006.
Zeppelin Laminectomy Rongeur K901372, [online] Retrieved from the internet: <URL: http://www.zeppelin-medical.com/download/instruments.pdf>. Oct. 24, 2006.

Cited By (1272)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US11812960B2 (en) 2004-07-28 2023-11-14 Cilag Gmbh International Method of segmenting the operation of a surgical stapling instrument
US11135352B2 (en) 2004-07-28 2021-10-05 Cilag Gmbh International End effector including a gradually releasable medical adjunct
US10568629B2 (en) 2004-07-28 2020-02-25 Ethicon Llc Articulating surgical stapling instrument
US11684365B2 (en) 2004-07-28 2023-06-27 Cilag Gmbh International Replaceable staple cartridges for surgical instruments
US11882987B2 (en) 2004-07-28 2024-01-30 Cilag Gmbh International Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US10485547B2 (en) 2004-07-28 2019-11-26 Ethicon Llc Surgical staple cartridges
US11116502B2 (en) 2004-07-28 2021-09-14 Cilag Gmbh International Surgical stapling instrument incorporating a two-piece firing mechanism
US10314590B2 (en) 2004-07-28 2019-06-11 Ethicon Llc Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
US10716563B2 (en) 2004-07-28 2020-07-21 Ethicon Llc Stapling system comprising an instrument assembly including a lockout
US10293100B2 (en) 2004-07-28 2019-05-21 Ethicon Llc Surgical stapling instrument having a medical substance dispenser
US10292707B2 (en) 2004-07-28 2019-05-21 Ethicon Llc Articulating surgical stapling instrument incorporating a firing mechanism
US10687817B2 (en) 2004-07-28 2020-06-23 Ethicon Llc Stapling device comprising a firing member lockout
US10383634B2 (en) 2004-07-28 2019-08-20 Ethicon Llc Stapling system incorporating a firing lockout
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US10278702B2 (en) 2004-07-28 2019-05-07 Ethicon Llc Stapling system comprising a firing bar and a lockout
US9510830B2 (en) 2004-07-28 2016-12-06 Ethicon Endo-Surgery, Llc Staple cartridge
US9585663B2 (en) 2004-07-28 2017-03-07 Ethicon Endo-Surgery, Llc Surgical stapling instrument configured to apply a compressive pressure to tissue
US11083456B2 (en) 2004-07-28 2021-08-10 Cilag Gmbh International Articulating surgical instrument incorporating a two-piece firing mechanism
US9282966B2 (en) 2004-07-28 2016-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US10799240B2 (en) 2004-07-28 2020-10-13 Ethicon Llc Surgical instrument comprising a staple firing lockout
US9737303B2 (en) 2004-07-28 2017-08-22 Ethicon Llc Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US9737302B2 (en) 2004-07-28 2017-08-22 Ethicon Llc Surgical stapling instrument having a restraining member
US9844379B2 (en) 2004-07-28 2017-12-19 Ethicon Llc Surgical stapling instrument having a clearanced opening
US9320618B2 (en) 2004-10-15 2016-04-26 Amendia, Inc. Access and tissue modification systems and methods
US9456829B2 (en) 2004-10-15 2016-10-04 Amendia, Inc. Powered tissue modification devices and methods
US9345491B2 (en) 2004-10-15 2016-05-24 Amendia, Inc. Flexible tissue rasp
US8568416B2 (en) 2004-10-15 2013-10-29 Baxano Surgical, Inc. Access and tissue modification systems and methods
US11484311B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US11172927B2 (en) 2005-08-31 2021-11-16 Cilag Gmbh International Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US9326768B2 (en) 2005-08-31 2016-05-03 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US10729436B2 (en) 2005-08-31 2020-08-04 Ethicon Llc Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US11730474B2 (en) 2005-08-31 2023-08-22 Cilag Gmbh International Fastener cartridge assembly comprising a movable cartridge and a staple driver arrangement
US10070863B2 (en) 2005-08-31 2018-09-11 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil
US10420553B2 (en) 2005-08-31 2019-09-24 Ethicon Llc Staple cartridge comprising a staple driver arrangement
US11134947B2 (en) 2005-08-31 2021-10-05 Cilag Gmbh International Fastener cartridge assembly comprising a camming sled with variable cam arrangements
US11771425B2 (en) 2005-08-31 2023-10-03 Cilag Gmbh International Stapling assembly for forming staples to different formed heights
US9307988B2 (en) 2005-08-31 2016-04-12 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US10463369B2 (en) 2005-08-31 2019-11-05 Ethicon Llc Disposable end effector for use with a surgical instrument
US10842488B2 (en) 2005-08-31 2020-11-24 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US10842489B2 (en) 2005-08-31 2020-11-24 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US10869664B2 (en) 2005-08-31 2020-12-22 Ethicon Llc End effector for use with a surgical stapling instrument
US10321909B2 (en) 2005-08-31 2019-06-18 Ethicon Llc Staple cartridge comprising a staple including deformable members
US11576673B2 (en) 2005-08-31 2023-02-14 Cilag Gmbh International Stapling assembly for forming staples to different heights
US9848873B2 (en) 2005-08-31 2017-12-26 Ethicon Llc Fastener cartridge assembly comprising a driver and staple cavity arrangement
US10245035B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Stapling assembly configured to produce different formed staple heights
US9844373B2 (en) 2005-08-31 2017-12-19 Ethicon Llc Fastener cartridge assembly comprising a driver row arrangement
US11179153B2 (en) 2005-08-31 2021-11-23 Cilag Gmbh International Staple cartridges for forming staples having differing formed staple heights
US9839427B2 (en) 2005-08-31 2017-12-12 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and a staple driver arrangement
US10932774B2 (en) 2005-08-31 2021-03-02 Ethicon Llc Surgical end effector for forming staples to different heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US9795382B2 (en) 2005-08-31 2017-10-24 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US11793512B2 (en) 2005-08-31 2023-10-24 Cilag Gmbh International Staple cartridges for forming staples having differing formed staple heights
US10245032B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Staple cartridges for forming staples having differing formed staple heights
US11399828B2 (en) 2005-08-31 2022-08-02 Cilag Gmbh International Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11272928B2 (en) 2005-08-31 2022-03-15 Cilag GmbH Intemational Staple cartridges for forming staples having differing formed staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US9592052B2 (en) 2005-08-31 2017-03-14 Ethicon Endo-Surgery, Llc Stapling assembly for forming different formed staple heights
US11090045B2 (en) 2005-08-31 2021-08-17 Cilag Gmbh International Staple cartridges for forming staples having differing formed staple heights
US10271845B2 (en) 2005-08-31 2019-04-30 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US9561032B2 (en) 2005-08-31 2017-02-07 Ethicon Endo-Surgery, Llc Staple cartridge comprising a staple driver arrangement
US10271846B2 (en) 2005-08-31 2019-04-30 Ethicon Llc Staple cartridge for use with a surgical stapler
US11839375B2 (en) 2005-08-31 2023-12-12 Cilag Gmbh International Fastener cartridge assembly comprising an anvil and different staple heights
US10278697B2 (en) 2005-08-31 2019-05-07 Ethicon Llc Staple cartridge comprising a staple driver arrangement
US9492151B2 (en) 2005-10-15 2016-11-15 Amendia, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US9125682B2 (en) 2005-10-15 2015-09-08 Amendia, Inc. Multiple pathways for spinal nerve root decompression from a single access point
US11793511B2 (en) 2005-11-09 2023-10-24 Cilag Gmbh International Surgical instruments
US10993713B2 (en) 2005-11-09 2021-05-04 Ethicon Llc Surgical instruments
US9895147B2 (en) 2005-11-09 2018-02-20 Ethicon Llc End effectors for surgical staplers
US9968356B2 (en) 2005-11-09 2018-05-15 Ethicon Llc Surgical instrument drive systems
US10806449B2 (en) 2005-11-09 2020-10-20 Ethicon Llc End effectors for surgical staplers
US10028742B2 (en) 2005-11-09 2018-07-24 Ethicon Llc Staple cartridge comprising staples with different unformed heights
US10149679B2 (en) 2005-11-09 2018-12-11 Ethicon Llc Surgical instrument comprising drive systems
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US10342533B2 (en) 2006-01-31 2019-07-09 Ethicon Llc Surgical instrument
US9320520B2 (en) 2006-01-31 2016-04-26 Ethicon Endo-Surgery, Inc. Surgical instrument system
US10278722B2 (en) 2006-01-31 2019-05-07 Ethicon Llc Motor-driven surgical cutting and fastening instrument
US10842491B2 (en) 2006-01-31 2020-11-24 Ethicon Llc Surgical system with an actuation console
US11051813B2 (en) 2006-01-31 2021-07-06 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US9326769B2 (en) 2006-01-31 2016-05-03 Ethicon Endo-Surgery, Llc Surgical instrument
US10426463B2 (en) 2006-01-31 2019-10-01 Ehticon LLC Surgical instrument having a feedback system
US9326770B2 (en) 2006-01-31 2016-05-03 Ethicon Endo-Surgery, Llc Surgical instrument
US11612393B2 (en) 2006-01-31 2023-03-28 Cilag Gmbh International Robotically-controlled end effector
US10806479B2 (en) 2006-01-31 2020-10-20 Ethicon Llc Motor-driven surgical cutting and fastening instrument with tactile position feedback
US11224454B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with tactile position feedback
US11364046B2 (en) 2006-01-31 2022-06-21 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with tactile position feedback
US10004498B2 (en) 2006-01-31 2018-06-26 Ethicon Llc Surgical instrument comprising a plurality of articulation joints
US10893853B2 (en) 2006-01-31 2021-01-19 Ethicon Llc Stapling assembly including motor drive systems
US11648024B2 (en) 2006-01-31 2023-05-16 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with position feedback
US11020113B2 (en) 2006-01-31 2021-06-01 Cilag Gmbh International Surgical instrument having force feedback capabilities
US10010322B2 (en) 2006-01-31 2018-07-03 Ethicon Llc Surgical instrument
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US11883020B2 (en) 2006-01-31 2024-01-30 Cilag Gmbh International Surgical instrument having a feedback system
US10463384B2 (en) 2006-01-31 2019-11-05 Ethicon Llc Stapling assembly
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US10463383B2 (en) 2006-01-31 2019-11-05 Ethicon Llc Stapling instrument including a sensing system
US11648008B2 (en) 2006-01-31 2023-05-16 Cilag Gmbh International Surgical instrument having force feedback capabilities
US9370358B2 (en) 2006-01-31 2016-06-21 Ethicon Endo-Surgery, Llc Motor-driven surgical cutting and fastening instrument with tactile position feedback
US11103269B2 (en) 2006-01-31 2021-08-31 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with tactile position feedback
US10052100B2 (en) 2006-01-31 2018-08-21 Ethicon Llc Surgical instrument system configured to detect resistive forces experienced by a tissue cutting implement
US11660110B2 (en) 2006-01-31 2023-05-30 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with tactile position feedback
US10052099B2 (en) 2006-01-31 2018-08-21 Ethicon Llc Surgical instrument system comprising a firing system including a rotatable shaft and first and second actuation ramps
US11051811B2 (en) 2006-01-31 2021-07-06 Ethicon Llc End effector for use with a surgical instrument
US10058963B2 (en) 2006-01-31 2018-08-28 Ethicon Llc Automated end effector component reloading system for use with a robotic system
US10485539B2 (en) 2006-01-31 2019-11-26 Ethicon Llc Surgical instrument with firing lockout
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US10499890B2 (en) 2006-01-31 2019-12-10 Ethicon Llc Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US9439649B2 (en) 2006-01-31 2016-09-13 Ethicon Endo-Surgery, Llc Surgical instrument having force feedback capabilities
US9113874B2 (en) 2006-01-31 2015-08-25 Ethicon Endo-Surgery, Inc. Surgical instrument system
US9451958B2 (en) 2006-01-31 2016-09-27 Ethicon Endo-Surgery, Llc Surgical instrument with firing actuator lockout
US11801051B2 (en) 2006-01-31 2023-10-31 Cilag Gmbh International Accessing data stored in a memory of a surgical instrument
US10653435B2 (en) 2006-01-31 2020-05-19 Ethicon Llc Motor-driven surgical cutting and fastening instrument with tactile position feedback
US10335144B2 (en) 2006-01-31 2019-07-02 Ethicon Llc Surgical instrument
US10743849B2 (en) 2006-01-31 2020-08-18 Ethicon Llc Stapling system including an articulation system
US10098636B2 (en) 2006-01-31 2018-10-16 Ethicon Llc Surgical instrument having force feedback capabilities
US11000275B2 (en) 2006-01-31 2021-05-11 Ethicon Llc Surgical instrument
US11890029B2 (en) 2006-01-31 2024-02-06 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument
US10993717B2 (en) 2006-01-31 2021-05-04 Ethicon Llc Surgical stapling system comprising a control system
US10918380B2 (en) 2006-01-31 2021-02-16 Ethicon Llc Surgical instrument system including a control system
US11350916B2 (en) 2006-01-31 2022-06-07 Cilag Gmbh International Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US11246616B2 (en) 2006-01-31 2022-02-15 Cilag Gmbh International Motor-driven surgical cutting and fastening instrument with tactile position feedback
US11890008B2 (en) 2006-01-31 2024-02-06 Cilag Gmbh International Surgical instrument with firing lockout
US9517068B2 (en) 2006-01-31 2016-12-13 Ethicon Endo-Surgery, Llc Surgical instrument with automatically-returned firing member
US10653417B2 (en) 2006-01-31 2020-05-19 Ethicon Llc Surgical instrument
US10709468B2 (en) 2006-01-31 2020-07-14 Ethicon Llc Motor-driven surgical cutting and fastening instrument
US10201363B2 (en) 2006-01-31 2019-02-12 Ethicon Llc Motor-driven surgical instrument
US10952728B2 (en) 2006-01-31 2021-03-23 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US10959722B2 (en) 2006-01-31 2021-03-30 Ethicon Llc Surgical instrument for deploying fasteners by way of rotational motion
US10299817B2 (en) 2006-01-31 2019-05-28 Ethicon Llc Motor-driven fastening assembly
US11166717B2 (en) 2006-01-31 2021-11-09 Cilag Gmbh International Surgical instrument with firing lockout
US11058420B2 (en) 2006-01-31 2021-07-13 Cilag Gmbh International Surgical stapling apparatus comprising a lockout system
US10675028B2 (en) 2006-01-31 2020-06-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US9743928B2 (en) 2006-01-31 2017-08-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US10070861B2 (en) 2006-03-23 2018-09-11 Ethicon Llc Articulatable surgical device
US8911471B2 (en) 2006-03-23 2014-12-16 Ethicon Endo-Surgery, Inc. Articulatable surgical device
US9492167B2 (en) 2006-03-23 2016-11-15 Ethicon Endo-Surgery, Llc Articulatable surgical device with rotary driven cutting member
US9301759B2 (en) 2006-03-23 2016-04-05 Ethicon Endo-Surgery, Llc Robotically-controlled surgical instrument with selectively articulatable end effector
US10213262B2 (en) 2006-03-23 2019-02-26 Ethicon Llc Manipulatable surgical systems with selectively articulatable fastening device
US10064688B2 (en) 2006-03-23 2018-09-04 Ethicon Llc Surgical system with selectively articulatable end effector
US9402626B2 (en) 2006-03-23 2016-08-02 Ethicon Endo-Surgery, Llc Rotary actuatable surgical fastener and cutter
US9351741B2 (en) 2006-05-04 2016-05-31 Amendia, Inc. Flexible tissue removal devices and methods
US10314589B2 (en) 2006-06-27 2019-06-11 Ethicon Llc Surgical instrument including a shifting assembly
US10420560B2 (en) 2006-06-27 2019-09-24 Ethicon Llc Manually driven surgical cutting and fastening instrument
US11272938B2 (en) 2006-06-27 2022-03-15 Cilag Gmbh International Surgical instrument including dedicated firing and retraction assemblies
US9320521B2 (en) 2006-06-27 2016-04-26 Ethicon Endo-Surgery, Llc Surgical instrument
US8845637B2 (en) 2006-08-29 2014-09-30 Baxano Surgical, Inc. Tissue access guidewire system and method
US11678876B2 (en) 2006-09-29 2023-06-20 Cilag Gmbh International Powered surgical instrument
US9408604B2 (en) 2006-09-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instrument comprising a firing system including a compliant portion
US11571231B2 (en) 2006-09-29 2023-02-07 Cilag Gmbh International Staple cartridge having a driver for driving multiple staples
US9179911B2 (en) 2006-09-29 2015-11-10 Ethicon Endo-Surgery, Inc. End effector for use with a surgical fastening instrument
US10595862B2 (en) 2006-09-29 2020-03-24 Ethicon Llc Staple cartridge including a compressible member
US11622785B2 (en) 2006-09-29 2023-04-11 Cilag Gmbh International Surgical staples having attached drivers and stapling instruments for deploying the same
US11633182B2 (en) 2006-09-29 2023-04-25 Cilag Gmbh International Surgical stapling assemblies
US8973804B2 (en) 2006-09-29 2015-03-10 Ethicon Endo-Surgery, Inc. Cartridge assembly having a buttressing member
US10448952B2 (en) 2006-09-29 2019-10-22 Ethicon Llc End effector for use with a surgical fastening instrument
US10695053B2 (en) 2006-09-29 2020-06-30 Ethicon Llc Surgical end effectors with staple cartridges
US8763875B2 (en) 2006-09-29 2014-07-01 Ethicon Endo-Surgery, Inc. End effector for use with a surgical fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US9706991B2 (en) 2006-09-29 2017-07-18 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples including a lateral base
US11406379B2 (en) 2006-09-29 2022-08-09 Cilag Gmbh International Surgical end effectors with staple cartridges
US10172616B2 (en) 2006-09-29 2019-01-08 Ethicon Llc Surgical staple cartridge
US9603595B2 (en) 2006-09-29 2017-03-28 Ethicon Endo-Surgery, Llc Surgical instrument comprising an adjustable system configured to accommodate different jaw heights
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US10342541B2 (en) 2006-10-03 2019-07-09 Ethicon Llc Surgical instruments with E-beam driver and rotary drive arrangements
US11877748B2 (en) 2006-10-03 2024-01-23 Cilag Gmbh International Robotically-driven surgical instrument with E-beam driver
US10206678B2 (en) 2006-10-03 2019-02-19 Ethicon Llc Surgical stapling instrument with lockout features to prevent advancement of a firing assembly unless an unfired surgical staple cartridge is operably mounted in an end effector portion of the instrument
US11382626B2 (en) 2006-10-03 2022-07-12 Cilag Gmbh International Surgical system including a knife bar supported for rotational and axial travel
US11849947B2 (en) 2007-01-10 2023-12-26 Cilag Gmbh International Surgical system including a control circuit and a passively-powered transponder
US11812961B2 (en) 2007-01-10 2023-11-14 Cilag Gmbh International Surgical instrument including a motor control system
US11771426B2 (en) 2007-01-10 2023-10-03 Cilag Gmbh International Surgical instrument with wireless communication
US11350929B2 (en) 2007-01-10 2022-06-07 Cilag Gmbh International Surgical instrument with wireless communication between control unit and sensor transponders
US11666332B2 (en) 2007-01-10 2023-06-06 Cilag Gmbh International Surgical instrument comprising a control circuit configured to adjust the operation of a motor
US11006951B2 (en) 2007-01-10 2021-05-18 Ethicon Llc Surgical instrument with wireless communication between control unit and sensor transponders
US10441369B2 (en) 2007-01-10 2019-10-15 Ethicon Llc Articulatable surgical instrument configured for detachable use with a robotic system
US9757123B2 (en) 2007-01-10 2017-09-12 Ethicon Llc Powered surgical instrument having a transmission system
US10751138B2 (en) 2007-01-10 2020-08-25 Ethicon Llc Surgical instrument for use with a robotic system
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US11844521B2 (en) 2007-01-10 2023-12-19 Cilag Gmbh International Surgical instrument for use with a robotic system
US11000277B2 (en) 2007-01-10 2021-05-11 Ethicon Llc Surgical instrument with wireless communication between control unit and remote sensor
US10433918B2 (en) 2007-01-10 2019-10-08 Ethicon Llc Surgical instrument system configured to evaluate the load applied to a firing member at the initiation of a firing stroke
US10952727B2 (en) 2007-01-10 2021-03-23 Ethicon Llc Surgical instrument for assessing the state of a staple cartridge
US10517590B2 (en) 2007-01-10 2019-12-31 Ethicon Llc Powered surgical instrument having a transmission system
US11064998B2 (en) 2007-01-10 2021-07-20 Cilag Gmbh International Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US10945729B2 (en) 2007-01-10 2021-03-16 Ethicon Llc Interlock and surgical instrument including same
US10517682B2 (en) 2007-01-10 2019-12-31 Ethicon Llc Surgical instrument with wireless communication between control unit and remote sensor
US10918386B2 (en) 2007-01-10 2021-02-16 Ethicon Llc Interlock and surgical instrument including same
US11166720B2 (en) 2007-01-10 2021-11-09 Cilag Gmbh International Surgical instrument including a control module for assessing an end effector
US11134943B2 (en) 2007-01-10 2021-10-05 Cilag Gmbh International Powered surgical instrument including a control unit and sensor
US10278780B2 (en) 2007-01-10 2019-05-07 Ethicon Llc Surgical instrument for use with robotic system
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US9675355B2 (en) 2007-01-11 2017-06-13 Ethicon Llc Surgical stapling device with a curved end effector
US9730692B2 (en) 2007-01-11 2017-08-15 Ethicon Llc Surgical stapling device with a curved staple cartridge
US9700321B2 (en) 2007-01-11 2017-07-11 Ethicon Llc Surgical stapling device having supports for a flexible drive mechanism
US9750501B2 (en) 2007-01-11 2017-09-05 Ethicon Endo-Surgery, Llc Surgical stapling devices having laterally movable anvils
US9603598B2 (en) 2007-01-11 2017-03-28 Ethicon Endo-Surgery, Llc Surgical stapling device with a curved end effector
US9724091B2 (en) 2007-01-11 2017-08-08 Ethicon Llc Surgical stapling device
US9775613B2 (en) 2007-01-11 2017-10-03 Ethicon Llc Surgical stapling device with a curved end effector
US10912575B2 (en) 2007-01-11 2021-02-09 Ethicon Llc Surgical stapling device having supports for a flexible drive mechanism
US9999431B2 (en) 2007-01-11 2018-06-19 Ethicon Endo-Surgery, Llc Surgical stapling device having supports for a flexible drive mechanism
US11839352B2 (en) 2007-01-11 2023-12-12 Cilag Gmbh International Surgical stapling device with an end effector
US9655624B2 (en) 2007-01-11 2017-05-23 Ethicon Llc Surgical stapling device with a curved end effector
US9757130B2 (en) 2007-02-28 2017-09-12 Ethicon Llc Stapling assembly for forming different formed staple heights
US8925788B2 (en) 2007-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. End effectors for surgical stapling instruments
US9872682B2 (en) 2007-03-15 2018-01-23 Ethicon Llc Surgical stapling instrument having a releasable buttress material
US9289206B2 (en) 2007-03-15 2016-03-22 Ethicon Endo-Surgery, Llc Lateral securement members for surgical staple cartridges
US10702267B2 (en) 2007-03-15 2020-07-07 Ethicon Llc Surgical stapling instrument having a releasable buttress material
US11337693B2 (en) 2007-03-15 2022-05-24 Cilag Gmbh International Surgical stapling instrument having a releasable buttress material
US10398433B2 (en) 2007-03-28 2019-09-03 Ethicon Llc Laparoscopic clamp load measuring devices
US11672531B2 (en) 2007-06-04 2023-06-13 Cilag Gmbh International Rotary drive systems for surgical instruments
US9795381B2 (en) 2007-06-04 2017-10-24 Ethicon Endo-Surgery, Llc Robotically-controlled shaft based rotary drive systems for surgical instruments
US10368863B2 (en) 2007-06-04 2019-08-06 Ethicon Llc Robotically-controlled shaft based rotary drive systems for surgical instruments
US9585658B2 (en) 2007-06-04 2017-03-07 Ethicon Endo-Surgery, Llc Stapling systems
US10363033B2 (en) 2007-06-04 2019-07-30 Ethicon Llc Robotically-controlled surgical instruments
US11648006B2 (en) 2007-06-04 2023-05-16 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US9186143B2 (en) 2007-06-04 2015-11-17 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US10299787B2 (en) 2007-06-04 2019-05-28 Ethicon Llc Stapling system comprising rotary inputs
US11559302B2 (en) 2007-06-04 2023-01-24 Cilag Gmbh International Surgical instrument including a firing member movable at different speeds
US11154298B2 (en) 2007-06-04 2021-10-26 Cilag Gmbh International Stapling system for use with a robotic surgical system
US10327765B2 (en) 2007-06-04 2019-06-25 Ethicon Llc Drive systems for surgical instruments
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US10441280B2 (en) 2007-06-04 2019-10-15 Ethicon Llc Robotically-controlled shaft based rotary drive systems for surgical instruments
US9750498B2 (en) 2007-06-04 2017-09-05 Ethicon Endo Surgery, Llc Drive systems for surgical instruments
US9987003B2 (en) 2007-06-04 2018-06-05 Ethicon Llc Robotic actuator assembly
US11134938B2 (en) 2007-06-04 2021-10-05 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US11147549B2 (en) 2007-06-04 2021-10-19 Cilag Gmbh International Stapling instrument including a firing system and a closure system
US11911028B2 (en) 2007-06-04 2024-02-27 Cilag Gmbh International Surgical instruments for use with a robotic surgical system
US9138225B2 (en) 2007-06-22 2015-09-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US11013511B2 (en) 2007-06-22 2021-05-25 Ethicon Llc Surgical stapling instrument with an articulatable end effector
US9662110B2 (en) 2007-06-22 2017-05-30 Ethicon Endo-Surgery, Llc Surgical stapling instrument with an articulatable end effector
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US9463029B2 (en) 2007-12-07 2016-10-11 Amendia, Inc. Tissue modification devices
US10765424B2 (en) 2008-02-13 2020-09-08 Ethicon Llc Surgical stapling instrument
US10639036B2 (en) 2008-02-14 2020-05-05 Ethicon Llc Robotically-controlled motorized surgical cutting and fastening instrument
US10898194B2 (en) 2008-02-14 2021-01-26 Ethicon Llc Detachable motor powered surgical instrument
US10463370B2 (en) 2008-02-14 2019-11-05 Ethicon Llc Motorized surgical instrument
US9204878B2 (en) 2008-02-14 2015-12-08 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US10874396B2 (en) 2008-02-14 2020-12-29 Ethicon Llc Stapling instrument for use with a surgical robot
US10470763B2 (en) 2008-02-14 2019-11-12 Ethicon Llc Surgical cutting and fastening instrument including a sensing system
US9901346B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US9901345B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US9901344B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US9498219B2 (en) 2008-02-14 2016-11-22 Ethicon Endo-Surgery, Llc Detachable motor powered surgical instrument
US10888330B2 (en) 2008-02-14 2021-01-12 Ethicon Llc Surgical system
US9522029B2 (en) 2008-02-14 2016-12-20 Ethicon Endo-Surgery, Llc Motorized surgical cutting and fastening instrument having handle based power source
US11446034B2 (en) 2008-02-14 2022-09-20 Cilag Gmbh International Surgical stapling assembly comprising first and second actuation systems configured to perform different functions
US9877723B2 (en) 2008-02-14 2018-01-30 Ethicon Llc Surgical stapling assembly comprising a selector arrangement
US9872684B2 (en) 2008-02-14 2018-01-23 Ethicon Llc Surgical stapling apparatus including firing force regulation
US9867618B2 (en) 2008-02-14 2018-01-16 Ethicon Llc Surgical stapling apparatus including firing force regulation
US11464514B2 (en) 2008-02-14 2022-10-11 Cilag Gmbh International Motorized surgical stapling system including a sensing array
US10542974B2 (en) 2008-02-14 2020-01-28 Ethicon Llc Surgical instrument including a control system
US11612395B2 (en) 2008-02-14 2023-03-28 Cilag Gmbh International Surgical system including a control system having an RFID tag reader
US10307163B2 (en) 2008-02-14 2019-06-04 Ethicon Llc Detachable motor powered surgical instrument
US9962158B2 (en) 2008-02-14 2018-05-08 Ethicon Llc Surgical stapling apparatuses with lockable end effector positioning systems
US8991677B2 (en) 2008-02-14 2015-03-31 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US8998058B2 (en) 2008-02-14 2015-04-07 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US10265067B2 (en) 2008-02-14 2019-04-23 Ethicon Llc Surgical instrument including a regulator and a control system
US11484307B2 (en) 2008-02-14 2022-11-01 Cilag Gmbh International Loading unit coupleable to a surgical stapling system
US9980729B2 (en) 2008-02-14 2018-05-29 Ethicon Endo-Surgery, Llc Detachable motor powered surgical instrument
US11801047B2 (en) 2008-02-14 2023-10-31 Cilag Gmbh International Surgical stapling system comprising a control circuit configured to selectively monitor tissue impedance and adjust control of a motor
US10806450B2 (en) 2008-02-14 2020-10-20 Ethicon Llc Surgical cutting and fastening instrument having a control system
US11571212B2 (en) 2008-02-14 2023-02-07 Cilag Gmbh International Surgical stapling system including an impedance sensor
US10238385B2 (en) 2008-02-14 2019-03-26 Ethicon Llc Surgical instrument system for evaluating tissue impedance
US10660640B2 (en) 2008-02-14 2020-05-26 Ethicon Llc Motorized surgical cutting and fastening instrument
US10238387B2 (en) 2008-02-14 2019-03-26 Ethicon Llc Surgical instrument comprising a control system
US9999426B2 (en) 2008-02-14 2018-06-19 Ethicon Llc Detachable motor powered surgical instrument
US10682142B2 (en) 2008-02-14 2020-06-16 Ethicon Llc Surgical stapling apparatus including an articulation system
US10888329B2 (en) 2008-02-14 2021-01-12 Ethicon Llc Detachable motor powered surgical instrument
US10206676B2 (en) 2008-02-14 2019-02-19 Ethicon Llc Surgical cutting and fastening instrument
US11638583B2 (en) 2008-02-14 2023-05-02 Cilag Gmbh International Motorized surgical system having a plurality of power sources
US10004505B2 (en) 2008-02-14 2018-06-26 Ethicon Llc Detachable motor powered surgical instrument
US10779822B2 (en) 2008-02-14 2020-09-22 Ethicon Llc System including a surgical cutting and fastening instrument
US10682141B2 (en) 2008-02-14 2020-06-16 Ethicon Llc Surgical device including a control system
US9211121B2 (en) 2008-02-14 2015-12-15 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US9072515B2 (en) 2008-02-14 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US11717285B2 (en) 2008-02-14 2023-08-08 Cilag Gmbh International Surgical cutting and fastening instrument having RF electrodes
US10898195B2 (en) 2008-02-14 2021-01-26 Ethicon Llc Detachable motor powered surgical instrument
US10716568B2 (en) 2008-02-14 2020-07-21 Ethicon Llc Surgical stapling apparatus with control features operable with one hand
US9084601B2 (en) 2008-02-14 2015-07-21 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US10722232B2 (en) 2008-02-14 2020-07-28 Ethicon Llc Surgical instrument for use with different cartridges
US9095339B2 (en) 2008-02-14 2015-08-04 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US10743870B2 (en) 2008-02-14 2020-08-18 Ethicon Llc Surgical stapling apparatus with interlockable firing system
US10925605B2 (en) 2008-02-14 2021-02-23 Ethicon Llc Surgical stapling system
US10743851B2 (en) 2008-02-14 2020-08-18 Ethicon Llc Interchangeable tools for surgical instruments
US10765432B2 (en) 2008-02-14 2020-09-08 Ethicon Llc Surgical device including a control system
US10905427B2 (en) 2008-02-14 2021-02-02 Ethicon Llc Surgical System
US10905426B2 (en) 2008-02-14 2021-02-02 Ethicon Llc Detachable motor powered surgical instrument
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US11154297B2 (en) 2008-02-15 2021-10-26 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US11058418B2 (en) 2008-02-15 2021-07-13 Cilag Gmbh International Surgical end effector having buttress retention features
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US10856866B2 (en) 2008-02-15 2020-12-08 Ethicon Llc Surgical end effector having buttress retention features
US10390823B2 (en) 2008-02-15 2019-08-27 Ethicon Llc End effector comprising an adjunct
US9314253B2 (en) 2008-07-01 2016-04-19 Amendia, Inc. Tissue modification devices and methods
WO2010009093A2 (en) 2008-07-14 2010-01-21 Baxano, Inc Tissue modification devices
US10258336B2 (en) 2008-09-19 2019-04-16 Ethicon Llc Stapling system configured to produce different formed staple heights
US11123071B2 (en) 2008-09-19 2021-09-21 Cilag Gmbh International Staple cartridge for us with a surgical instrument
US11871923B2 (en) 2008-09-23 2024-01-16 Cilag Gmbh International Motorized surgical instrument
US10736628B2 (en) 2008-09-23 2020-08-11 Ethicon Llc Motor-driven surgical cutting instrument
US11617576B2 (en) 2008-09-23 2023-04-04 Cilag Gmbh International Motor-driven surgical cutting instrument
US10105136B2 (en) 2008-09-23 2018-10-23 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US10980535B2 (en) 2008-09-23 2021-04-20 Ethicon Llc Motorized surgical instrument with an end effector
US11103241B2 (en) 2008-09-23 2021-08-31 Cilag Gmbh International Motor-driven surgical cutting instrument
US10485537B2 (en) 2008-09-23 2019-11-26 Ethicon Llc Motorized surgical instrument
US11684361B2 (en) 2008-09-23 2023-06-27 Cilag Gmbh International Motor-driven surgical cutting instrument
US11406380B2 (en) 2008-09-23 2022-08-09 Cilag Gmbh International Motorized surgical instrument
US10238389B2 (en) 2008-09-23 2019-03-26 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US11517304B2 (en) 2008-09-23 2022-12-06 Cilag Gmbh International Motor-driven surgical cutting instrument
US10765425B2 (en) 2008-09-23 2020-09-08 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US10130361B2 (en) 2008-09-23 2018-11-20 Ethicon Llc Robotically-controller motorized surgical tool with an end effector
US10898184B2 (en) 2008-09-23 2021-01-26 Ethicon Llc Motor-driven surgical cutting instrument
US11617575B2 (en) 2008-09-23 2023-04-04 Cilag Gmbh International Motor-driven surgical cutting instrument
US11812954B2 (en) 2008-09-23 2023-11-14 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US10456133B2 (en) 2008-09-23 2019-10-29 Ethicon Llc Motorized surgical instrument
US9655614B2 (en) 2008-09-23 2017-05-23 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument with an end effector
US10420549B2 (en) 2008-09-23 2019-09-24 Ethicon Llc Motorized surgical instrument
US11045189B2 (en) 2008-09-23 2021-06-29 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US10045778B2 (en) 2008-09-23 2018-08-14 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US10149683B2 (en) 2008-10-10 2018-12-11 Ethicon Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US11793521B2 (en) 2008-10-10 2023-10-24 Cilag Gmbh International Powered surgical cutting and stapling apparatus with manually retractable firing system
US9370364B2 (en) 2008-10-10 2016-06-21 Ethicon Endo-Surgery, Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US11583279B2 (en) 2008-10-10 2023-02-21 Cilag Gmbh International Powered surgical cutting and stapling apparatus with manually retractable firing system
US10932778B2 (en) 2008-10-10 2021-03-02 Ethicon Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US11730477B2 (en) 2008-10-10 2023-08-22 Cilag Gmbh International Powered surgical system with manually retractable firing system
US10758233B2 (en) 2009-02-05 2020-09-01 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US11129615B2 (en) 2009-02-05 2021-09-28 Cilag Gmbh International Surgical stapling system
US9393015B2 (en) 2009-02-06 2016-07-19 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with cutting member reversing mechanism
US9486214B2 (en) 2009-02-06 2016-11-08 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with switching system configured to prevent firing initiation until activated
US10420550B2 (en) 2009-02-06 2019-09-24 Ethicon Llc Motor driven surgical fastener device with switching system configured to prevent firing initiation until activated
US11291449B2 (en) 2009-12-24 2022-04-05 Cilag Gmbh International Surgical cutting instrument that analyzes tissue thickness
US10751076B2 (en) 2009-12-24 2020-08-25 Ethicon Llc Motor-driven surgical cutting instrument with electric actuator directional control assembly
US10596002B2 (en) 2010-01-04 2020-03-24 Rti Surgical, Inc. Sacroiliac fusion system
US11173036B2 (en) 2010-01-04 2021-11-16 Surgalign Spine Technologies, Inc. Sacroiliac fusion system
US11737882B2 (en) 2010-01-04 2023-08-29 Surgalign Spine Technologies, Inc. Sacroiliac fusion system
US11478247B2 (en) 2010-07-30 2022-10-25 Cilag Gmbh International Tissue acquisition arrangements and methods for surgical stapling devices
US9131940B2 (en) 2010-09-29 2015-09-15 Ethicon Endo-Surgery, Inc. Staple cartridge
US10130363B2 (en) 2010-09-29 2018-11-20 Ethicon Llc Staple cartridge
US10898191B2 (en) 2010-09-29 2021-01-26 Ethicon Llc Fastener cartridge
US11571213B2 (en) 2010-09-29 2023-02-07 Cilag Gmbh International Staple cartridge
US9282962B2 (en) 2010-09-30 2016-03-15 Ethicon Endo-Surgery, Llc Adhesive film laminate
US11602340B2 (en) 2010-09-30 2023-03-14 Cilag Gmbh International Adhesive film laminate
US11571215B2 (en) 2010-09-30 2023-02-07 Cilag Gmbh International Layer of material for a surgical end effector
US10987102B2 (en) 2010-09-30 2021-04-27 Ethicon Llc Tissue thickness compensator comprising a plurality of layers
US11559496B2 (en) 2010-09-30 2023-01-24 Cilag Gmbh International Tissue thickness compensator configured to redistribute compressive forces
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9848875B2 (en) 2010-09-30 2017-12-26 Ethicon Llc Anvil layer attached to a proximal end of an end effector
US11737754B2 (en) 2010-09-30 2023-08-29 Cilag Gmbh International Surgical stapler with floating anvil
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US10064624B2 (en) 2010-09-30 2018-09-04 Ethicon Llc End effector with implantable layer
US9826978B2 (en) 2010-09-30 2017-11-28 Ethicon Llc End effectors with same side closure and firing motions
US9844372B2 (en) 2010-09-30 2017-12-19 Ethicon Llc Retainer assembly including a tissue thickness compensator
US9320518B2 (en) 2010-09-30 2016-04-26 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an oxygen generating agent
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US9044227B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Collapsible fastener cartridge
US10624861B2 (en) 2010-09-30 2020-04-21 Ethicon Llc Tissue thickness compensator configured to redistribute compressive forces
US10194910B2 (en) 2010-09-30 2019-02-05 Ethicon Llc Stapling assemblies comprising a layer
US9700317B2 (en) 2010-09-30 2017-07-11 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasable tissue thickness compensator
US9044228B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Fastener system comprising a plurality of fastener cartridges
US9277919B2 (en) 2010-09-30 2016-03-08 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising fibers to produce a resilient load
US9861361B2 (en) 2010-09-30 2018-01-09 Ethicon Llc Releasable tissue thickness compensator and fastener cartridge having the same
US10258330B2 (en) 2010-09-30 2019-04-16 Ethicon Llc End effector including an implantable arrangement
US10258332B2 (en) 2010-09-30 2019-04-16 Ethicon Llc Stapling system comprising an adjunct and a flowable adhesive
US11540824B2 (en) 2010-09-30 2023-01-03 Cilag Gmbh International Tissue thickness compensator
US9016542B2 (en) 2010-09-30 2015-04-28 Ethicon Endo-Surgery, Inc. Staple cartridge comprising compressible distortion resistant components
US10182819B2 (en) 2010-09-30 2019-01-22 Ethicon Llc Implantable layer assemblies
US20120080479A1 (en) * 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge comprising multiple layers
US9833242B2 (en) 2010-09-30 2017-12-05 Ethicon Endo-Surgery, Llc Tissue thickness compensators
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US10265074B2 (en) 2010-09-30 2019-04-23 Ethicon Llc Implantable layers for surgical stapling devices
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US10265072B2 (en) 2010-09-30 2019-04-23 Ethicon Llc Surgical stapling system comprising an end effector including an implantable layer
US10588623B2 (en) 2010-09-30 2020-03-17 Ethicon Llc Adhesive film laminate
US9795383B2 (en) 2010-09-30 2017-10-24 Ethicon Llc Tissue thickness compensator comprising resilient members
US11911027B2 (en) 2010-09-30 2024-02-27 Cilag Gmbh International Adhesive film laminate
US10888328B2 (en) 2010-09-30 2021-01-12 Ethicon Llc Surgical end effector
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US8978954B2 (en) 2010-09-30 2015-03-17 Ethicon Endo-Surgery, Inc. Staple cartridge comprising an adjustable distal portion
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US10028743B2 (en) 2010-09-30 2018-07-24 Ethicon Llc Staple cartridge assembly comprising an implantable layer
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9615826B2 (en) 2010-09-30 2017-04-11 Ethicon Endo-Surgery, Llc Multiple thickness implantable layers for surgical stapling devices
US8925782B2 (en) * 2010-09-30 2015-01-06 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge comprising multiple layers
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US9592053B2 (en) 2010-09-30 2017-03-14 Ethicon Endo-Surgery, Llc Staple cartridge comprising multiple regions
US10149682B2 (en) 2010-09-30 2018-12-11 Ethicon Llc Stapling system including an actuation system
US9592050B2 (en) 2010-09-30 2017-03-14 Ethicon Endo-Surgery, Llc End effector comprising a distal tissue abutment member
US10548600B2 (en) 2010-09-30 2020-02-04 Ethicon Llc Multiple thickness implantable layers for surgical stapling devices
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US8899463B2 (en) 2010-09-30 2014-12-02 Ethicon Endo-Surgery, Inc. Surgical staple cartridges supporting non-linearly arranged staples and surgical stapling instruments with common staple-forming pockets
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US10835251B2 (en) 2010-09-30 2020-11-17 Ethicon Llc Surgical instrument assembly including an end effector configurable in different positions
US9572574B2 (en) 2010-09-30 2017-02-21 Ethicon Endo-Surgery, Llc Tissue thickness compensators comprising therapeutic agents
US10213198B2 (en) 2010-09-30 2019-02-26 Ethicon Llc Actuator for releasing a tissue thickness compensator from a fastener cartridge
US8864007B2 (en) 2010-09-30 2014-10-21 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge having a non-uniform arrangement
US9924947B2 (en) 2010-09-30 2018-03-27 Ethicon Llc Staple cartridge comprising a compressible portion
US9566061B2 (en) 2010-09-30 2017-02-14 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasably attached tissue thickness compensator
US11583277B2 (en) 2010-09-30 2023-02-21 Cilag Gmbh International Layer of material for a surgical end effector
US10136890B2 (en) 2010-09-30 2018-11-27 Ethicon Llc Staple cartridge comprising a variable thickness compressible portion
US11083452B2 (en) 2010-09-30 2021-08-10 Cilag Gmbh International Staple cartridge including a tissue thickness compensator
US11406377B2 (en) 2010-09-30 2022-08-09 Cilag Gmbh International Adhesive film laminate
US11684360B2 (en) 2010-09-30 2023-06-27 Cilag Gmbh International Staple cartridge comprising a variable thickness compressible portion
US11850310B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge including an adjunct
US9295464B2 (en) 2010-09-30 2016-03-29 Ethicon Endo-Surgery, Inc. Surgical stapler anvil comprising a plurality of forming pockets
US10123798B2 (en) 2010-09-30 2018-11-13 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9480476B2 (en) 2010-09-30 2016-11-01 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising resilient members
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US11857187B2 (en) 2010-09-30 2024-01-02 Cilag Gmbh International Tissue thickness compensator comprising controlled release and expansion
US10335150B2 (en) 2010-09-30 2019-07-02 Ethicon Llc Staple cartridge comprising an implantable layer
US10335148B2 (en) 2010-09-30 2019-07-02 Ethicon Llc Staple cartridge including a tissue thickness compensator for a surgical stapler
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US11883025B2 (en) 2010-09-30 2024-01-30 Cilag Gmbh International Tissue thickness compensator comprising a plurality of layers
US9433419B2 (en) 2010-09-30 2016-09-06 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of layers
US10485536B2 (en) 2010-09-30 2019-11-26 Ethicon Llc Tissue stapler having an anti-microbial agent
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US9307965B2 (en) 2010-09-30 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-microbial agent
US9801634B2 (en) 2010-09-30 2017-10-31 Ethicon Llc Tissue thickness compensator for a surgical stapler
US8840003B2 (en) 2010-09-30 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with compact articulation control arrangement
US10363031B2 (en) 2010-09-30 2019-07-30 Ethicon Llc Tissue thickness compensators for surgical staplers
US10743877B2 (en) 2010-09-30 2020-08-18 Ethicon Llc Surgical stapler with floating anvil
US10869669B2 (en) 2010-09-30 2020-12-22 Ethicon Llc Surgical instrument assembly
US8783542B2 (en) 2010-09-30 2014-07-22 Ethicon Endo-Surgery, Inc. Fasteners supported by a fastener cartridge support
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US9808247B2 (en) 2010-09-30 2017-11-07 Ethicon Llc Stapling system comprising implantable layers
US9833238B2 (en) 2010-09-30 2017-12-05 Ethicon Endo-Surgery, Llc Retainer assembly including a tissue thickness compensator
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9833236B2 (en) 2010-09-30 2017-12-05 Ethicon Llc Tissue thickness compensator for surgical staplers
US10463372B2 (en) 2010-09-30 2019-11-05 Ethicon Llc Staple cartridge comprising multiple regions
US9814462B2 (en) 2010-09-30 2017-11-14 Ethicon Llc Assembly for fastening tissue comprising a compressible layer
US9358005B2 (en) 2010-09-30 2016-06-07 Ethicon Endo-Surgery, Llc End effector layer including holding features
US9883861B2 (en) 2010-09-30 2018-02-06 Ethicon Llc Retainer assembly including a tissue thickness compensator
US11672536B2 (en) 2010-09-30 2023-06-13 Cilag Gmbh International Layer of material for a surgical end effector
US10898193B2 (en) 2010-09-30 2021-01-26 Ethicon Llc End effector for use with a surgical instrument
US10398436B2 (en) 2010-09-30 2019-09-03 Ethicon Llc Staple cartridge comprising staples positioned within a compressible portion thereof
US11154296B2 (en) 2010-09-30 2021-10-26 Cilag Gmbh International Anvil layer attached to a proximal end of an end effector
US11395651B2 (en) 2010-09-30 2022-07-26 Cilag Gmbh International Adhesive film laminate
US9345477B2 (en) 2010-09-30 2016-05-24 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator comprising incorporating a hemostatic agent
US10405854B2 (en) 2010-09-30 2019-09-10 Ethicon Llc Surgical stapling cartridge with layer retention features
US10695062B2 (en) 2010-10-01 2020-06-30 Ethicon Llc Surgical instrument including a retractable firing member
US11529142B2 (en) 2010-10-01 2022-12-20 Cilag Gmbh International Surgical instrument having a power control circuit
US9351730B2 (en) 2011-04-29 2016-05-31 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising channels
US10117652B2 (en) 2011-04-29 2018-11-06 Ethicon Llc End effector comprising a tissue thickness compensator and progressively released attachment members
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
US11504116B2 (en) 2011-04-29 2022-11-22 Cilag Gmbh International Layer of material for a surgical end effector
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US11583278B2 (en) 2011-05-27 2023-02-21 Cilag Gmbh International Surgical stapling system having multi-direction articulation
US10383633B2 (en) 2011-05-27 2019-08-20 Ethicon Llc Robotically-driven surgical assembly
US10426478B2 (en) 2011-05-27 2019-10-01 Ethicon Llc Surgical stapling systems
US10980534B2 (en) 2011-05-27 2021-04-20 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US10004506B2 (en) 2011-05-27 2018-06-26 Ethicon Llc Surgical system
US10524790B2 (en) 2011-05-27 2020-01-07 Ethicon Llc Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US10335151B2 (en) 2011-05-27 2019-07-02 Ethicon Llc Robotically-driven surgical instrument
US9775614B2 (en) 2011-05-27 2017-10-03 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotatable staple deployment arrangements
US10420561B2 (en) 2011-05-27 2019-09-24 Ethicon Llc Robotically-driven surgical instrument
US11129616B2 (en) 2011-05-27 2021-09-28 Cilag Gmbh International Surgical stapling system
US10617420B2 (en) 2011-05-27 2020-04-14 Ethicon Llc Surgical system comprising drive systems
US10813641B2 (en) 2011-05-27 2020-10-27 Ethicon Llc Robotically-driven surgical instrument
US10485546B2 (en) 2011-05-27 2019-11-26 Ethicon Llc Robotically-driven surgical assembly
US11266410B2 (en) 2011-05-27 2022-03-08 Cilag Gmbh International Surgical device for use with a robotic system
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US10231794B2 (en) 2011-05-27 2019-03-19 Ethicon Llc Surgical stapling instruments with rotatable staple deployment arrangements
US11612394B2 (en) 2011-05-27 2023-03-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US9913648B2 (en) 2011-05-27 2018-03-13 Ethicon Endo-Surgery, Llc Surgical system
US10071452B2 (en) 2011-05-27 2018-09-11 Ethicon Llc Automated end effector component reloading system for use with a robotic system
US11439470B2 (en) 2011-05-27 2022-09-13 Cilag Gmbh International Robotically-controlled surgical instrument with selectively articulatable end effector
US10130366B2 (en) 2011-05-27 2018-11-20 Ethicon Llc Automated reloading devices for replacing used end effectors on robotic surgical systems
US10736634B2 (en) 2011-05-27 2020-08-11 Ethicon Llc Robotically-driven surgical instrument including a drive system
US9271799B2 (en) 2011-05-27 2016-03-01 Ethicon Endo-Surgery, Llc Robotic surgical system with removable motor housing
US10780539B2 (en) 2011-05-27 2020-09-22 Ethicon Llc Stapling instrument for use with a robotic system
US9492170B2 (en) * 2011-08-10 2016-11-15 Ethicon Endo-Surgery, Inc. Device for applying adjunct in endoscopic procedure
US20130037596A1 (en) * 2011-08-10 2013-02-14 Brian W. Bear Device for applying adjunct in endoscopic procedure
US9687237B2 (en) 2011-09-23 2017-06-27 Ethicon Endo-Surgery, Llc Staple cartridge including collapsible deck arrangement
US9216019B2 (en) 2011-09-23 2015-12-22 Ethicon Endo-Surgery, Inc. Surgical stapler with stationary staple drivers
US9592054B2 (en) 2011-09-23 2017-03-14 Ethicon Endo-Surgery, Llc Surgical stapler with stationary staple drivers
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9730697B2 (en) 2012-02-13 2017-08-15 Ethicon Endo-Surgery, Llc Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US10695063B2 (en) 2012-02-13 2020-06-30 Ethicon Llc Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US9974538B2 (en) 2012-03-28 2018-05-22 Ethicon Llc Staple cartridge comprising a compressible layer
US10667808B2 (en) 2012-03-28 2020-06-02 Ethicon Llc Staple cartridge comprising an absorbable adjunct
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US11406378B2 (en) 2012-03-28 2022-08-09 Cilag Gmbh International Staple cartridge comprising a compressible tissue thickness compensator
US9918716B2 (en) 2012-03-28 2018-03-20 Ethicon Llc Staple cartridge comprising implantable layers
US11793509B2 (en) 2012-03-28 2023-10-24 Cilag Gmbh International Staple cartridge including an implantable layer
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US10441285B2 (en) 2012-03-28 2019-10-15 Ethicon Llc Tissue thickness compensator comprising tissue ingrowth features
US9724098B2 (en) 2012-03-28 2017-08-08 Ethicon Endo-Surgery, Llc Staple cartridge comprising an implantable layer
US9314247B2 (en) 2012-03-28 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating a hydrophilic agent
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US10959725B2 (en) 2012-06-15 2021-03-30 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US10064621B2 (en) 2012-06-15 2018-09-04 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US11707273B2 (en) 2012-06-15 2023-07-25 Cilag Gmbh International Articulatable surgical instrument comprising a firing drive
US11602346B2 (en) 2012-06-28 2023-03-14 Cilag Gmbh International Robotically powered surgical device with manually-actuatable reversing system
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US10420555B2 (en) 2012-06-28 2019-09-24 Ethicon Llc Hand held rotary powered surgical instruments with end effectors that are articulatable about multiple axes
US11278284B2 (en) 2012-06-28 2022-03-22 Cilag Gmbh International Rotary drive arrangements for surgical instruments
US11622766B2 (en) 2012-06-28 2023-04-11 Cilag Gmbh International Empty clip cartridge lockout
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US11154299B2 (en) 2012-06-28 2021-10-26 Cilag Gmbh International Stapling assembly comprising a firing lockout
US11534162B2 (en) 2012-06-28 2022-12-27 Cilag GmbH Inlernational Robotically powered surgical device with manually-actuatable reversing system
US10413294B2 (en) 2012-06-28 2019-09-17 Ethicon Llc Shaft assembly arrangements for surgical instruments
US11510671B2 (en) 2012-06-28 2022-11-29 Cilag Gmbh International Firing system lockout arrangements for surgical instruments
US11141156B2 (en) 2012-06-28 2021-10-12 Cilag Gmbh International Surgical stapling assembly comprising flexible output shaft
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US10874391B2 (en) 2012-06-28 2020-12-29 Ethicon Llc Surgical instrument system including replaceable end effectors
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US11141155B2 (en) 2012-06-28 2021-10-12 Cilag Gmbh International Drive system for surgical tool
US11007004B2 (en) 2012-06-28 2021-05-18 Ethicon Llc Powered multi-axial articulable electrosurgical device with external dissection features
US10932775B2 (en) 2012-06-28 2021-03-02 Ethicon Llc Firing system lockout arrangements for surgical instruments
US11039837B2 (en) 2012-06-28 2021-06-22 Cilag Gmbh International Firing system lockout arrangements for surgical instruments
US10383630B2 (en) 2012-06-28 2019-08-20 Ethicon Llc Surgical stapling device with rotary driven firing member
US9649111B2 (en) 2012-06-28 2017-05-16 Ethicon Endo-Surgery, Llc Replaceable clip cartridge for a clip applier
US11464513B2 (en) 2012-06-28 2022-10-11 Cilag Gmbh International Surgical instrument system including replaceable end effectors
US11241230B2 (en) 2012-06-28 2022-02-08 Cilag Gmbh International Clip applier tool for use with a robotic surgical system
US11540829B2 (en) 2012-06-28 2023-01-03 Cilag Gmbh International Surgical instrument system including replaceable end effectors
US10687812B2 (en) 2012-06-28 2020-06-23 Ethicon Llc Surgical instrument system including replaceable end effectors
US11058423B2 (en) 2012-06-28 2021-07-13 Cilag Gmbh International Stapling system including first and second closure systems for use with a surgical robot
US9907620B2 (en) 2012-06-28 2018-03-06 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
US11857189B2 (en) 2012-06-28 2024-01-02 Cilag Gmbh International Surgical instrument including first and second articulation joints
US11806013B2 (en) 2012-06-28 2023-11-07 Cilag Gmbh International Firing system arrangements for surgical instruments
US10258333B2 (en) 2012-06-28 2019-04-16 Ethicon Llc Surgical fastening apparatus with a rotary end effector drive shaft for selective engagement with a motorized drive system
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
US11083457B2 (en) 2012-06-28 2021-08-10 Cilag Gmbh International Surgical instrument system including replaceable end effectors
US10639115B2 (en) 2012-06-28 2020-05-05 Ethicon Llc Surgical end effectors having angled tissue-contacting surfaces
US11779420B2 (en) 2012-06-28 2023-10-10 Cilag Gmbh International Robotic surgical attachments having manually-actuated retraction assemblies
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
US10485541B2 (en) 2012-06-28 2019-11-26 Ethicon Llc Robotically powered surgical device with manually-actuatable reversing system
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US11109860B2 (en) 2012-06-28 2021-09-07 Cilag Gmbh International Surgical end effectors for use with hand-held and robotically-controlled rotary powered surgical systems
US11373755B2 (en) 2012-08-23 2022-06-28 Cilag Gmbh International Surgical device drive system including a ratchet mechanism
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US9307986B2 (en) 2013-03-01 2016-04-12 Ethicon Endo-Surgery, Llc Surgical instrument soft stop
US9554794B2 (en) 2013-03-01 2017-01-31 Ethicon Endo-Surgery, Llc Multiple processor motor control for modular surgical instruments
US10285695B2 (en) 2013-03-01 2019-05-14 Ethicon Llc Articulatable surgical instruments with conductive pathways
US10575868B2 (en) 2013-03-01 2020-03-03 Ethicon Llc Surgical instrument with coupler assembly
US11246618B2 (en) 2013-03-01 2022-02-15 Cilag Gmbh International Surgical instrument soft stop
US9782169B2 (en) 2013-03-01 2017-10-10 Ethicon Llc Rotary powered articulation joints for surgical instruments
US10226249B2 (en) 2013-03-01 2019-03-12 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US11529138B2 (en) 2013-03-01 2022-12-20 Cilag Gmbh International Powered surgical instrument including a rotary drive screw
US9700309B2 (en) 2013-03-01 2017-07-11 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US9358003B2 (en) 2013-03-01 2016-06-07 Ethicon Endo-Surgery, Llc Electromechanical surgical device with signal relay arrangement
US9398911B2 (en) 2013-03-01 2016-07-26 Ethicon Endo-Surgery, Llc Rotary powered surgical instruments with multiple degrees of freedom
US9468438B2 (en) 2013-03-01 2016-10-18 Eticon Endo-Surgery, LLC Sensor straightened end effector during removal through trocar
US9326767B2 (en) 2013-03-01 2016-05-03 Ethicon Endo-Surgery, Llc Joystick switch assemblies for surgical instruments
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
US10617416B2 (en) 2013-03-14 2020-04-14 Ethicon Llc Control systems for surgical instruments
US9351727B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Drive train control arrangements for modular surgical instruments
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9808244B2 (en) 2013-03-14 2017-11-07 Ethicon Llc Sensor arrangements for absolute positioning system for surgical instruments
US9888919B2 (en) 2013-03-14 2018-02-13 Ethicon Llc Method and system for operating a surgical instrument
US10893867B2 (en) 2013-03-14 2021-01-19 Ethicon Llc Drive train control arrangements for modular surgical instruments
US10470762B2 (en) 2013-03-14 2019-11-12 Ethicon Llc Multi-function motor for a surgical instrument
US9629623B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgery, Llc Drive system lockout arrangements for modular surgical instruments
US9351726B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Articulation control system for articulatable surgical instruments
US10238391B2 (en) 2013-03-14 2019-03-26 Ethicon Llc Drive train control arrangements for modular surgical instruments
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US11266406B2 (en) 2013-03-14 2022-03-08 Cilag Gmbh International Control systems for surgical instruments
US9883860B2 (en) 2013-03-14 2018-02-06 Ethicon Llc Interchangeable shaft assemblies for use with a surgical instrument
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US10149680B2 (en) 2013-04-16 2018-12-11 Ethicon Llc Surgical instrument comprising a gap setting system
US9867612B2 (en) 2013-04-16 2018-01-16 Ethicon Llc Powered surgical stapler
US11633183B2 (en) 2013-04-16 2023-04-25 Cilag International GmbH Stapling assembly comprising a retraction drive
US9844368B2 (en) 2013-04-16 2017-12-19 Ethicon Llc Surgical system comprising first and second drive systems
US9814460B2 (en) 2013-04-16 2017-11-14 Ethicon Llc Modular motor driven surgical instruments with status indication arrangements
US10405857B2 (en) 2013-04-16 2019-09-10 Ethicon Llc Powered linear surgical stapler
US9801626B2 (en) 2013-04-16 2017-10-31 Ethicon Llc Modular motor driven surgical instruments with alignment features for aligning rotary drive shafts with surgical end effector shafts
US9826976B2 (en) 2013-04-16 2017-11-28 Ethicon Llc Motor driven surgical instruments with lockable dual drive shafts
US11564679B2 (en) 2013-04-16 2023-01-31 Cilag Gmbh International Powered surgical stapler
US10136887B2 (en) 2013-04-16 2018-11-27 Ethicon Llc Drive system decoupling arrangement for a surgical instrument
US10888318B2 (en) 2013-04-16 2021-01-12 Ethicon Llc Powered surgical stapler
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US11395652B2 (en) 2013-04-16 2022-07-26 Cilag Gmbh International Powered surgical stapler
US10702266B2 (en) 2013-04-16 2020-07-07 Ethicon Llc Surgical instrument system
US11622763B2 (en) 2013-04-16 2023-04-11 Cilag Gmbh International Stapling assembly comprising a shiftable drive
US11638581B2 (en) 2013-04-16 2023-05-02 Cilag Gmbh International Powered surgical stapler
US11690615B2 (en) 2013-04-16 2023-07-04 Cilag Gmbh International Surgical system including an electric motor and a surgical instrument
US11406381B2 (en) 2013-04-16 2022-08-09 Cilag Gmbh International Powered surgical stapler
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US11504119B2 (en) 2013-08-23 2022-11-22 Cilag Gmbh International Surgical instrument including an electronic firing lockout
US9445813B2 (en) 2013-08-23 2016-09-20 Ethicon Endo-Surgery, Llc Closure indicator systems for surgical instruments
US11701110B2 (en) 2013-08-23 2023-07-18 Cilag Gmbh International Surgical instrument including a drive assembly movable in a non-motorized mode of operation
US11109858B2 (en) 2013-08-23 2021-09-07 Cilag Gmbh International Surgical instrument including a display which displays the position of a firing element
US11134940B2 (en) 2013-08-23 2021-10-05 Cilag Gmbh International Surgical instrument including a variable speed firing member
US10869665B2 (en) 2013-08-23 2020-12-22 Ethicon Llc Surgical instrument system including a control system
US11026680B2 (en) 2013-08-23 2021-06-08 Cilag Gmbh International Surgical instrument configured to operate in different states
US11389160B2 (en) 2013-08-23 2022-07-19 Cilag Gmbh International Surgical system comprising a display
US10624634B2 (en) 2013-08-23 2020-04-21 Ethicon Llc Firing trigger lockout arrangements for surgical instruments
US9924942B2 (en) 2013-08-23 2018-03-27 Ethicon Llc Motor-powered articulatable surgical instruments
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
US11000274B2 (en) 2013-08-23 2021-05-11 Ethicon Llc Powered surgical instrument
US9987006B2 (en) 2013-08-23 2018-06-05 Ethicon Llc Shroud retention arrangement for sterilizable surgical instruments
US11376001B2 (en) 2013-08-23 2022-07-05 Cilag Gmbh International Surgical stapling device with rotary multi-turn retraction mechanism
US10898190B2 (en) 2013-08-23 2021-01-26 Ethicon Llc Secondary battery arrangements for powered surgical instruments
US10201349B2 (en) 2013-08-23 2019-02-12 Ethicon Llc End effector detection and firing rate modulation systems for surgical instruments
US11133106B2 (en) 2013-08-23 2021-09-28 Cilag Gmbh International Surgical instrument assembly comprising a retraction assembly
US9775609B2 (en) 2013-08-23 2017-10-03 Ethicon Llc Tamper proof circuit for surgical instrument battery pack
US9510828B2 (en) 2013-08-23 2016-12-06 Ethicon Endo-Surgery, Llc Conductor arrangements for electrically powered surgical instruments with rotatable end effectors
US10441281B2 (en) 2013-08-23 2019-10-15 Ethicon Llc surgical instrument including securing and aligning features
US9283054B2 (en) 2013-08-23 2016-03-15 Ethicon Endo-Surgery, Llc Interactive displays
US9808249B2 (en) 2013-08-23 2017-11-07 Ethicon Llc Attachment portions for surgical instrument assemblies
US10828032B2 (en) 2013-08-23 2020-11-10 Ethicon Llc End effector detection systems for surgical instruments
US11896223B2 (en) 2013-12-23 2024-02-13 Cilag Gmbh International Surgical cutting and stapling instruments with independent jaw control features
US11779327B2 (en) 2013-12-23 2023-10-10 Cilag Gmbh International Surgical stapling system including a push bar
US10265065B2 (en) 2013-12-23 2019-04-23 Ethicon Llc Surgical staples and staple cartridges
US11246587B2 (en) 2013-12-23 2022-02-15 Cilag Gmbh International Surgical cutting and stapling instruments
US11759201B2 (en) 2013-12-23 2023-09-19 Cilag Gmbh International Surgical stapling system comprising an end effector including an anvil with an anvil cap
US10925599B2 (en) 2013-12-23 2021-02-23 Ethicon Llc Modular surgical instruments
US11364028B2 (en) 2013-12-23 2022-06-21 Cilag Gmbh International Modular surgical system
US10588624B2 (en) 2013-12-23 2020-03-17 Ethicon Llc Surgical staples, staple cartridges and surgical end effectors
US11123065B2 (en) 2013-12-23 2021-09-21 Cilag Gmbh International Surgical cutting and stapling instruments with independent jaw control features
US11020109B2 (en) 2013-12-23 2021-06-01 Ethicon Llc Surgical stapling assembly for use with a powered surgical interface
US11583273B2 (en) 2013-12-23 2023-02-21 Cilag Gmbh International Surgical stapling system including a firing beam extending through an articulation region
US11026677B2 (en) 2013-12-23 2021-06-08 Cilag Gmbh International Surgical stapling assembly
US20180221033A1 (en) * 2014-01-09 2018-08-09 Rti Surgical, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US11707285B2 (en) * 2014-01-09 2023-07-25 Surgalign Spine Technologies, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US20150190149A1 (en) * 2014-01-09 2015-07-09 Zyga Technology, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US20210275194A1 (en) * 2014-01-09 2021-09-09 Surgalign Spine Technologies, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US10952750B2 (en) * 2014-01-09 2021-03-23 Surgalign Spine Technologies, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US9861375B2 (en) * 2014-01-09 2018-01-09 Zyga Technology, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US10271859B2 (en) * 2014-01-09 2019-04-30 Rti Surgical, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US11020115B2 (en) 2014-02-12 2021-06-01 Cilag Gmbh International Deliverable surgical instrument
US9757124B2 (en) 2014-02-24 2017-09-12 Ethicon Llc Implantable layer assemblies
US9884456B2 (en) 2014-02-24 2018-02-06 Ethicon Llc Implantable layers and methods for altering one or more properties of implantable layers for use with fastening instruments
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
US10426481B2 (en) 2014-02-24 2019-10-01 Ethicon Llc Implantable layer assemblies
US9775608B2 (en) 2014-02-24 2017-10-03 Ethicon Llc Fastening system comprising a firing member lockout
US9839423B2 (en) 2014-02-24 2017-12-12 Ethicon Llc Implantable layers and methods for modifying the shape of the implantable layers for use with a surgical fastening instrument
US9839422B2 (en) 2014-02-24 2017-12-12 Ethicon Llc Implantable layers and methods for altering implantable layers for use with surgical fastening instruments
US10667804B2 (en) 2014-03-17 2020-06-02 Evalve, Inc. Mitral valve fixation device removal devices and methods
US10004497B2 (en) 2014-03-26 2018-06-26 Ethicon Llc Interface systems for use with surgical instruments
US11497488B2 (en) 2014-03-26 2022-11-15 Cilag Gmbh International Systems and methods for controlling a segmented circuit
US9743929B2 (en) 2014-03-26 2017-08-29 Ethicon Llc Modular powered surgical instrument with detachable shaft assemblies
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US11259799B2 (en) 2014-03-26 2022-03-01 Cilag Gmbh International Interface systems for use with surgical instruments
US10201364B2 (en) 2014-03-26 2019-02-12 Ethicon Llc Surgical instrument comprising a rotatable shaft
US9733663B2 (en) 2014-03-26 2017-08-15 Ethicon Llc Power management through segmented circuit and variable voltage protection
US9730695B2 (en) 2014-03-26 2017-08-15 Ethicon Endo-Surgery, Llc Power management through segmented circuit
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
US10898185B2 (en) 2014-03-26 2021-01-26 Ethicon Llc Surgical instrument power management through sleep and wake up control
US9750499B2 (en) 2014-03-26 2017-09-05 Ethicon Llc Surgical stapling instrument system
US9804618B2 (en) 2014-03-26 2017-10-31 Ethicon Llc Systems and methods for controlling a segmented circuit
US10117653B2 (en) 2014-03-26 2018-11-06 Ethicon Llc Systems and methods for controlling a segmented circuit
US10588626B2 (en) 2014-03-26 2020-03-17 Ethicon Llc Surgical instrument displaying subsequent step of use
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US10136889B2 (en) 2014-03-26 2018-11-27 Ethicon Llc Systems and methods for controlling a segmented circuit
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9690362B2 (en) 2014-03-26 2017-06-27 Ethicon Llc Surgical instrument control circuit having a safety processor
US9826977B2 (en) 2014-03-26 2017-11-28 Ethicon Llc Sterilization verification circuit
US10863981B2 (en) 2014-03-26 2020-12-15 Ethicon Llc Interface systems for use with surgical instruments
US10327776B2 (en) 2014-04-16 2019-06-25 Ethicon Llc Surgical stapling buttresses and adjunct materials
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
US9833241B2 (en) 2014-04-16 2017-12-05 Ethicon Llc Surgical fastener cartridges with driver stabilizing arrangements
US10010324B2 (en) 2014-04-16 2018-07-03 Ethicon Llc Fastener cartridge compromising fastener cavities including fastener control features
US11717294B2 (en) 2014-04-16 2023-08-08 Cilag Gmbh International End effector arrangements comprising indicators
US11596406B2 (en) 2014-04-16 2023-03-07 Cilag Gmbh International Fastener cartridges including extensions having different configurations
US11266409B2 (en) 2014-04-16 2022-03-08 Cilag Gmbh International Fastener cartridge comprising a sled including longitudinally-staggered ramps
US11298134B2 (en) 2014-04-16 2022-04-12 Cilag Gmbh International Fastener cartridge comprising non-uniform fasteners
US10470768B2 (en) 2014-04-16 2019-11-12 Ethicon Llc Fastener cartridge including a layer attached thereto
US11883026B2 (en) 2014-04-16 2024-01-30 Cilag Gmbh International Fastener cartridge assemblies and staple retainer cover arrangements
US10561422B2 (en) 2014-04-16 2020-02-18 Ethicon Llc Fastener cartridge comprising deployable tissue engaging members
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
US11185330B2 (en) 2014-04-16 2021-11-30 Cilag Gmbh International Fastener cartridge assemblies and staple retainer cover arrangements
US10542988B2 (en) 2014-04-16 2020-01-28 Ethicon Llc End effector comprising an anvil including projections extending therefrom
US11382627B2 (en) 2014-04-16 2022-07-12 Cilag Gmbh International Surgical stapling assembly comprising a firing member including a lateral extension
US11517315B2 (en) 2014-04-16 2022-12-06 Cilag Gmbh International Fastener cartridges including extensions having different configurations
US9877721B2 (en) 2014-04-16 2018-01-30 Ethicon Llc Fastener cartridge comprising tissue control features
US11382625B2 (en) 2014-04-16 2022-07-12 Cilag Gmbh International Fastener cartridge comprising non-uniform fasteners
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US10905423B2 (en) 2014-09-05 2021-02-02 Ethicon Llc Smart cartridge wake up operation and data retention
US9737301B2 (en) 2014-09-05 2017-08-22 Ethicon Llc Monitoring device degradation based on component evaluation
US9788836B2 (en) 2014-09-05 2017-10-17 Ethicon Llc Multiple motor control for powered medical device
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US11653918B2 (en) 2014-09-05 2023-05-23 Cilag Gmbh International Local display of tissue parameter stabilization
US11406386B2 (en) 2014-09-05 2022-08-09 Cilag Gmbh International End effector including magnetic and impedance sensors
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US11717297B2 (en) 2014-09-05 2023-08-08 Cilag Gmbh International Smart cartridge wake up operation and data retention
US10135242B2 (en) 2014-09-05 2018-11-20 Ethicon Llc Smart cartridge wake up operation and data retention
US11389162B2 (en) 2014-09-05 2022-07-19 Cilag Gmbh International Smart cartridge wake up operation and data retention
US9757128B2 (en) 2014-09-05 2017-09-12 Ethicon Llc Multiple sensors with one sensor affecting a second sensor's output or interpretation
US10016199B2 (en) 2014-09-05 2018-07-10 Ethicon Llc Polarity of hall magnet to identify cartridge type
US11076854B2 (en) 2014-09-05 2021-08-03 Cilag Gmbh International Smart cartridge wake up operation and data retention
US11071545B2 (en) 2014-09-05 2021-07-27 Cilag Gmbh International Smart cartridge wake up operation and data retention
US11284898B2 (en) 2014-09-18 2022-03-29 Cilag Gmbh International Surgical instrument including a deployable knife
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
US10426477B2 (en) 2014-09-26 2019-10-01 Ethicon Llc Staple cartridge assembly including a ramp
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US11202633B2 (en) 2014-09-26 2021-12-21 Cilag Gmbh International Surgical stapling buttresses and adjunct materials
US10751053B2 (en) 2014-09-26 2020-08-25 Ethicon Llc Fastener cartridges for applying expandable fastener lines
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
US10426476B2 (en) 2014-09-26 2019-10-01 Ethicon Llc Circular fastener cartridges for applying radially expandable fastener lines
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US10206677B2 (en) 2014-09-26 2019-02-19 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
US10736630B2 (en) 2014-10-13 2020-08-11 Ethicon Llc Staple cartridge
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US11185325B2 (en) 2014-10-16 2021-11-30 Cilag Gmbh International End effector including different tissue gaps
US11701114B2 (en) 2014-10-16 2023-07-18 Cilag Gmbh International Staple cartridge
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10052104B2 (en) 2014-10-16 2018-08-21 Ethicon Llc Staple cartridge comprising a tissue thickness compensator
US10905418B2 (en) 2014-10-16 2021-02-02 Ethicon Llc Staple cartridge comprising a tissue thickness compensator
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11864760B2 (en) 2014-10-29 2024-01-09 Cilag Gmbh International Staple cartridges comprising driver arrangements
US11241229B2 (en) 2014-10-29 2022-02-08 Cilag Gmbh International Staple cartridges comprising driver arrangements
US11457918B2 (en) 2014-10-29 2022-10-04 Cilag Gmbh International Cartridge assemblies for surgical staplers
US10617417B2 (en) 2014-11-06 2020-04-14 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US11337698B2 (en) 2014-11-06 2022-05-24 Cilag Gmbh International Staple cartridge comprising a releasable adjunct material
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US11000316B2 (en) 2014-11-26 2021-05-11 Ex Technology, Llc Method and apparatus for joint fusion
US9931141B2 (en) 2014-11-26 2018-04-03 Ex Technology, Llc Method and apparatus for joint fusion
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US11382628B2 (en) 2014-12-10 2022-07-12 Cilag Gmbh International Articulatable surgical instrument system
US11517311B2 (en) 2014-12-18 2022-12-06 Cilag Gmbh International Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US11083453B2 (en) 2014-12-18 2021-08-10 Cilag Gmbh International Surgical stapling system including a flexible firing actuator and lateral buckling supports
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9968355B2 (en) 2014-12-18 2018-05-15 Ethicon Llc Surgical instruments with articulatable end effectors and improved firing beam support arrangements
US11553911B2 (en) 2014-12-18 2023-01-17 Cilag Gmbh International Surgical instrument assembly comprising a flexible articulation system
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US10004501B2 (en) 2014-12-18 2018-06-26 Ethicon Llc Surgical instruments with improved closure arrangements
US10695058B2 (en) 2014-12-18 2020-06-30 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US11571207B2 (en) 2014-12-18 2023-02-07 Cilag Gmbh International Surgical system including lateral supports for a flexible drive member
US10806448B2 (en) 2014-12-18 2020-10-20 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US11547403B2 (en) 2014-12-18 2023-01-10 Cilag Gmbh International Surgical instrument having a laminate firing actuator and lateral buckling supports
US10245027B2 (en) 2014-12-18 2019-04-02 Ethicon Llc Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge
US11399831B2 (en) 2014-12-18 2022-08-02 Cilag Gmbh International Drive arrangements for articulatable surgical instruments
US11547404B2 (en) 2014-12-18 2023-01-10 Cilag Gmbh International Surgical instrument assembly comprising a flexible articulation system
US10743873B2 (en) 2014-12-18 2020-08-18 Ethicon Llc Drive arrangements for articulatable surgical instruments
US10945728B2 (en) 2014-12-18 2021-03-16 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US11812958B2 (en) 2014-12-18 2023-11-14 Cilag Gmbh International Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US11678877B2 (en) 2014-12-18 2023-06-20 Cilag Gmbh International Surgical instrument including a flexible support configured to support a flexible firing member
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US11744588B2 (en) 2015-02-27 2023-09-05 Cilag Gmbh International Surgical stapling instrument including a removably attachable battery pack
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US10321907B2 (en) 2015-02-27 2019-06-18 Ethicon Llc System for monitoring whether a surgical instrument needs to be serviced
US11324506B2 (en) 2015-02-27 2022-05-10 Cilag Gmbh International Modular stapling assembly
US10182816B2 (en) 2015-02-27 2019-01-22 Ethicon Llc Charging system that enables emergency resolutions for charging a battery
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US9931118B2 (en) 2015-02-27 2018-04-03 Ethicon Endo-Surgery, Llc Reinforced battery for a surgical instrument
US10245028B2 (en) 2015-02-27 2019-04-02 Ethicon Llc Power adapter for a surgical instrument
US10159483B2 (en) 2015-02-27 2018-12-25 Ethicon Llc Surgical apparatus configured to track an end-of-life parameter
US10045779B2 (en) 2015-02-27 2018-08-14 Ethicon Llc Surgical instrument system comprising an inspection station
US11109859B2 (en) 2015-03-06 2021-09-07 Cilag Gmbh International Surgical instrument comprising a lockable battery housing
US11826132B2 (en) 2015-03-06 2023-11-28 Cilag Gmbh International Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US11426160B2 (en) 2015-03-06 2022-08-30 Cilag Gmbh International Smart sensors with local signal processing
US10729432B2 (en) 2015-03-06 2020-08-04 Ethicon Llc Methods for operating a powered surgical instrument
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US10772625B2 (en) 2015-03-06 2020-09-15 Ethicon Llc Signal and power communication system positioned on a rotatable shaft
US11350843B2 (en) 2015-03-06 2022-06-07 Cilag Gmbh International Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US10206605B2 (en) 2015-03-06 2019-02-19 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US10531887B2 (en) 2015-03-06 2020-01-14 Ethicon Llc Powered surgical instrument including speed display
US10052044B2 (en) 2015-03-06 2018-08-21 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10524787B2 (en) 2015-03-06 2020-01-07 Ethicon Llc Powered surgical instrument with parameter-based firing rate
US11224423B2 (en) 2015-03-06 2022-01-18 Cilag Gmbh International Smart sensors with local signal processing
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10966627B2 (en) 2015-03-06 2021-04-06 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10433890B2 (en) 2015-03-25 2019-10-08 Coracoid Solutions, Llc Joint repair system
US11564722B2 (en) 2015-03-25 2023-01-31 Coracoid Solutions, Llc Joint repair system
US10470808B2 (en) 2015-03-25 2019-11-12 Coracoid Solutions, Llc Joint repair system
US10390825B2 (en) 2015-03-31 2019-08-27 Ethicon Llc Surgical instrument with progressive rotary drive systems
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10433844B2 (en) 2015-03-31 2019-10-08 Ethicon Llc Surgical instrument with selectively disengageable threaded drive systems
US10052102B2 (en) 2015-06-18 2018-08-21 Ethicon Llc Surgical end effectors with dual cam actuated jaw closing features
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
US10617418B2 (en) 2015-08-17 2020-04-14 Ethicon Llc Implantable layers for a surgical instrument
US10980538B2 (en) 2015-08-26 2021-04-20 Ethicon Llc Surgical stapling configurations for curved and circular stapling instruments
US11058426B2 (en) 2015-08-26 2021-07-13 Cilag Gmbh International Staple cartridge assembly comprising various tissue compression gaps and staple forming gaps
US10357251B2 (en) 2015-08-26 2019-07-23 Ethicon Llc Surgical staples comprising hardness variations for improved fastening of tissue
US11219456B2 (en) 2015-08-26 2022-01-11 Cilag Gmbh International Surgical staple strips for permitting varying staple properties and enabling easy cartridge loading
US10966724B2 (en) 2015-08-26 2021-04-06 Ethicon Llc Surgical staples comprising a guide
US10098642B2 (en) 2015-08-26 2018-10-16 Ethicon Llc Surgical staples comprising features for improved fastening of tissue
US10213203B2 (en) 2015-08-26 2019-02-26 Ethicon Llc Staple cartridge assembly without a bottom cover
US10390829B2 (en) 2015-08-26 2019-08-27 Ethicon Llc Staples comprising a cover
US10188394B2 (en) 2015-08-26 2019-01-29 Ethicon Llc Staples configured to support an implantable adjunct
US10517599B2 (en) 2015-08-26 2019-12-31 Ethicon Llc Staple cartridge assembly comprising staple cavities for providing better staple guidance
US10433845B2 (en) 2015-08-26 2019-10-08 Ethicon Llc Surgical staple strips for permitting varying staple properties and enabling easy cartridge loading
US10166026B2 (en) 2015-08-26 2019-01-01 Ethicon Llc Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom
US11051817B2 (en) 2015-08-26 2021-07-06 Cilag Gmbh International Method for forming a staple against an anvil of a surgical stapling instrument
US11510675B2 (en) 2015-08-26 2022-11-29 Cilag Gmbh International Surgical end effector assembly including a connector strip interconnecting a plurality of staples
US10470769B2 (en) 2015-08-26 2019-11-12 Ethicon Llc Staple cartridge assembly comprising staple alignment features on a firing member
US11103248B2 (en) 2015-08-26 2021-08-31 Cilag Gmbh International Surgical staples for minimizing staple roll
US10314587B2 (en) 2015-09-02 2019-06-11 Ethicon Llc Surgical staple cartridge with improved staple driver configurations
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
US11382624B2 (en) 2015-09-02 2022-07-12 Cilag Gmbh International Surgical staple cartridge with improved staple driver configurations
US10357252B2 (en) 2015-09-02 2019-07-23 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples
US10251648B2 (en) 2015-09-02 2019-04-09 Ethicon Llc Surgical staple cartridge staple drivers with central support features
US10238390B2 (en) 2015-09-02 2019-03-26 Ethicon Llc Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns
US11213295B2 (en) 2015-09-02 2022-01-04 Cilag Gmbh International Surgical staple configurations with camming surfaces located between portions supporting surgical staples
US11589868B2 (en) 2015-09-02 2023-02-28 Cilag Gmbh International Surgical staple configurations with camming surfaces located between portions supporting surgical staples
US11490889B2 (en) 2015-09-23 2022-11-08 Cilag Gmbh International Surgical stapler having motor control based on an electrical parameter related to a motor current
US11026678B2 (en) 2015-09-23 2021-06-08 Cilag Gmbh International Surgical stapler having motor control based on an electrical parameter related to a motor current
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US11344299B2 (en) 2015-09-23 2022-05-31 Cilag Gmbh International Surgical stapler having downstream current-based motor control
US10863986B2 (en) 2015-09-23 2020-12-15 Ethicon Llc Surgical stapler having downstream current-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US11849946B2 (en) 2015-09-23 2023-12-26 Cilag Gmbh International Surgical stapler having downstream current-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US11076929B2 (en) 2015-09-25 2021-08-03 Cilag Gmbh International Implantable adjunct systems for determining adjunct skew
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US11793522B2 (en) 2015-09-30 2023-10-24 Cilag Gmbh International Staple cartridge assembly including a compressible adjunct
US10285699B2 (en) 2015-09-30 2019-05-14 Ethicon Llc Compressible adjunct
US10603039B2 (en) 2015-09-30 2020-03-31 Ethicon Llc Progressively releasable implantable adjunct for use with a surgical stapling instrument
US11553916B2 (en) 2015-09-30 2023-01-17 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10307160B2 (en) 2015-09-30 2019-06-04 Ethicon Llc Compressible adjunct assemblies with attachment layers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US11690623B2 (en) 2015-09-30 2023-07-04 Cilag Gmbh International Method for applying an implantable layer to a fastener cartridge
US10561420B2 (en) 2015-09-30 2020-02-18 Ethicon Llc Tubular absorbable constructs
US11712244B2 (en) 2015-09-30 2023-08-01 Cilag Gmbh International Implantable layer with spacer fibers
US10327777B2 (en) 2015-09-30 2019-06-25 Ethicon Llc Implantable layer comprising plastically deformed fibers
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10172620B2 (en) 2015-09-30 2019-01-08 Ethicon Llc Compressible adjuncts with bonding nodes
US10433846B2 (en) 2015-09-30 2019-10-08 Ethicon Llc Compressible adjunct with crossing spacer fibers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
US10932779B2 (en) 2015-09-30 2021-03-02 Ethicon Llc Compressible adjunct with crossing spacer fibers
US10524788B2 (en) 2015-09-30 2020-01-07 Ethicon Llc Compressible adjunct with attachment regions
US11903586B2 (en) 2015-09-30 2024-02-20 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US10271849B2 (en) 2015-09-30 2019-04-30 Ethicon Llc Woven constructs with interlocked standing fibers
US11484309B2 (en) 2015-12-30 2022-11-01 Cilag Gmbh International Surgical stapling system comprising a controller configured to cause a motor to reset a firing sequence
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11058422B2 (en) 2015-12-30 2021-07-13 Cilag Gmbh International Mechanisms for compensating for battery pack failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US11759208B2 (en) 2015-12-30 2023-09-19 Cilag Gmbh International Mechanisms for compensating for battery pack failure in powered surgical instruments
US11129613B2 (en) 2015-12-30 2021-09-28 Cilag Gmbh International Surgical instruments with separable motors and motor control circuits
US11083454B2 (en) 2015-12-30 2021-08-10 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10653413B2 (en) 2016-02-09 2020-05-19 Ethicon Llc Surgical instruments with an end effector that is highly articulatable relative to an elongate shaft assembly
US10245030B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instruments with tensioning arrangements for cable driven articulation systems
US11523823B2 (en) 2016-02-09 2022-12-13 Cilag Gmbh International Surgical instruments with non-symmetrical articulation arrangements
US10433837B2 (en) 2016-02-09 2019-10-08 Ethicon Llc Surgical instruments with multiple link articulation arrangements
US10413291B2 (en) 2016-02-09 2019-09-17 Ethicon Llc Surgical instrument articulation mechanism with slotted secondary constraint
US10470764B2 (en) 2016-02-09 2019-11-12 Ethicon Llc Surgical instruments with closure stroke reduction arrangements
US11730471B2 (en) 2016-02-09 2023-08-22 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
US10245029B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instrument with articulating and axially translatable end effector
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11779336B2 (en) 2016-02-12 2023-10-10 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11826045B2 (en) 2016-02-12 2023-11-28 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11344303B2 (en) 2016-02-12 2022-05-31 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10376263B2 (en) 2016-04-01 2019-08-13 Ethicon Llc Anvil modification members for surgical staplers
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US11317910B2 (en) 2016-04-15 2022-05-03 Cilag Gmbh International Surgical instrument with detection sensors
US11051810B2 (en) 2016-04-15 2021-07-06 Cilag Gmbh International Modular surgical instrument with configurable operating mode
US11284891B2 (en) 2016-04-15 2022-03-29 Cilag Gmbh International Surgical instrument with multiple program responses during a firing motion
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US11191545B2 (en) 2016-04-15 2021-12-07 Cilag Gmbh International Staple formation detection mechanisms
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US11771454B2 (en) 2016-04-15 2023-10-03 Cilag Gmbh International Stapling assembly including a controller for monitoring a clamping laod
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US11350932B2 (en) 2016-04-15 2022-06-07 Cilag Gmbh International Surgical instrument with improved stop/start control during a firing motion
US11311292B2 (en) 2016-04-15 2022-04-26 Cilag Gmbh International Surgical instrument with detection sensors
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US11642125B2 (en) 2016-04-15 2023-05-09 Cilag Gmbh International Robotic surgical system including a user interface and a control circuit
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11517306B2 (en) 2016-04-15 2022-12-06 Cilag Gmbh International Surgical instrument with detection sensors
US11026684B2 (en) 2016-04-15 2021-06-08 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US11350928B2 (en) 2016-04-18 2022-06-07 Cilag Gmbh International Surgical instrument comprising a tissue thickness lockout and speed control system
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US10363037B2 (en) 2016-04-18 2019-07-30 Ethicon Llc Surgical instrument system comprising a magnetic lockout
US11811253B2 (en) 2016-04-18 2023-11-07 Cilag Gmbh International Surgical robotic system with fault state detection configurations based on motor current draw
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US11559303B2 (en) 2016-04-18 2023-01-24 Cilag Gmbh International Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US10426469B2 (en) 2016-04-18 2019-10-01 Ethicon Llc Surgical instrument comprising a primary firing lockout and a secondary firing lockout
US10478181B2 (en) 2016-04-18 2019-11-19 Ethicon Llc Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US11147554B2 (en) 2016-04-18 2021-10-19 Cilag Gmbh International Surgical instrument system comprising a magnetic lockout
US10368867B2 (en) 2016-04-18 2019-08-06 Ethicon Llc Surgical instrument comprising a lockout
USD896380S1 (en) 2016-06-24 2020-09-15 Ethicon Llc Surgical fastener cartridge
US11000278B2 (en) 2016-06-24 2021-05-11 Ethicon Llc Staple cartridge comprising wire staples and stamped staples
US11786246B2 (en) 2016-06-24 2023-10-17 Cilag Gmbh International Stapling system for use with wire staples and stamped staples
US10675024B2 (en) 2016-06-24 2020-06-09 Ethicon Llc Staple cartridge comprising overdriven staples
US10893863B2 (en) 2016-06-24 2021-01-19 Ethicon Llc Staple cartridge comprising offset longitudinal staple rows
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
USD948043S1 (en) 2016-06-24 2022-04-05 Cilag Gmbh International Surgical fastener
USD896379S1 (en) 2016-06-24 2020-09-15 Ethicon Llc Surgical fastener cartridge
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
US10702270B2 (en) 2016-06-24 2020-07-07 Ethicon Llc Stapling system for use with wire staples and stamped staples
US11690619B2 (en) 2016-06-24 2023-07-04 Cilag Gmbh International Staple cartridge comprising staples having different geometries
US10542979B2 (en) 2016-06-24 2020-01-28 Ethicon Llc Stamped staples and staple cartridges using the same
USD894389S1 (en) 2016-06-24 2020-08-25 Ethicon Llc Surgical fastener
US10736632B2 (en) 2016-07-06 2020-08-11 Evalve, Inc. Methods and devices for valve clip excision
JP2019520917A (en) * 2016-07-06 2019-07-25 エバルブ・インコーポレイテッド Method and apparatus for valve clip ablation
CN109561891A (en) * 2016-07-06 2019-04-02 埃瓦尔维公司 Method and apparatus for the excision of valve clip
WO2018009718A1 (en) * 2016-07-06 2018-01-11 Revive Medical, LLC Methods and devices for valve clip excision
CN109561891B (en) * 2016-07-06 2021-09-28 埃瓦尔维公司 Method and apparatus for valve clip resection
US11653947B2 (en) 2016-10-05 2023-05-23 Evalve, Inc. Cardiac valve cutting device
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
US20200281621A1 (en) * 2016-12-16 2020-09-10 Beth Israel Deaconess Medical Center, Inc. Image guided spinal decompression with contralateral oblique view
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US10624635B2 (en) 2016-12-21 2020-04-21 Ethicon Llc Firing members with non-parallel jaw engagement features for surgical end effectors
US10517595B2 (en) 2016-12-21 2019-12-31 Ethicon Llc Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector
US10524789B2 (en) 2016-12-21 2020-01-07 Ethicon Llc Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration
US10537325B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Staple forming pocket arrangement to accommodate different types of staples
US11224428B2 (en) 2016-12-21 2022-01-18 Cilag Gmbh International Surgical stapling systems
US10537324B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Stepped staple cartridge with asymmetrical staples
US10898186B2 (en) 2016-12-21 2021-01-26 Ethicon Llc Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls
US10517596B2 (en) 2016-12-21 2019-12-31 Ethicon Llc Articulatable surgical instruments with articulation stroke amplification features
US10542982B2 (en) 2016-12-21 2020-01-28 Ethicon Llc Shaft assembly comprising first and second articulation lockouts
US10568625B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US11191540B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Protective cover arrangements for a joint interface between a movable jaw and actuator shaft of a surgical instrument
US11350935B2 (en) 2016-12-21 2022-06-07 Cilag Gmbh International Surgical tool assemblies with closure stroke reduction features
US11191543B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Assembly comprising a lock
US11350934B2 (en) 2016-12-21 2022-06-07 Cilag Gmbh International Staple forming pocket arrangement to accommodate different types of staples
US10568626B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Surgical instruments with jaw opening features for increasing a jaw opening distance
US11191539B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system
US11179155B2 (en) 2016-12-21 2021-11-23 Cilag Gmbh International Anvil arrangements for surgical staplers
US10568624B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems
US11369376B2 (en) 2016-12-21 2022-06-28 Cilag Gmbh International Surgical stapling systems
US10582928B2 (en) 2016-12-21 2020-03-10 Ethicon Llc Articulation lock arrangements for locking an end effector in an articulated position in response to actuation of a jaw closure system
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10588631B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical instruments with positive jaw opening features
US11564688B2 (en) 2016-12-21 2023-01-31 Cilag Gmbh International Robotic surgical tool having a retraction mechanism
US10588630B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical tool assemblies with closure stroke reduction features
US11160553B2 (en) 2016-12-21 2021-11-02 Cilag Gmbh International Surgical stapling systems
US11160551B2 (en) 2016-12-21 2021-11-02 Cilag Gmbh International Articulatable surgical stapling instruments
US11849948B2 (en) 2016-12-21 2023-12-26 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US10905422B2 (en) 2016-12-21 2021-02-02 Ethicon Llc Surgical instrument for use with a robotic surgical system
US10603036B2 (en) 2016-12-21 2020-03-31 Ethicon Llc Articulatable surgical instrument with independent pivotable linkage distal of an articulation lock
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
US11571210B2 (en) 2016-12-21 2023-02-07 Cilag Gmbh International Firing assembly comprising a multiple failed-state fuse
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10881401B2 (en) 2016-12-21 2021-01-05 Ethicon Llc Staple firing member comprising a missing cartridge and/or spent cartridge lockout
US10918385B2 (en) 2016-12-21 2021-02-16 Ethicon Llc Surgical system comprising a firing member rotatable into an articulation state to articulate an end effector of the surgical system
US10610224B2 (en) 2016-12-21 2020-04-07 Ethicon Llc Lockout arrangements for surgical end effectors and replaceable tool assemblies
US11096689B2 (en) 2016-12-21 2021-08-24 Cilag Gmbh International Shaft assembly comprising a lockout
US10617414B2 (en) 2016-12-21 2020-04-14 Ethicon Llc Closure member arrangements for surgical instruments
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US11000276B2 (en) 2016-12-21 2021-05-11 Ethicon Llc Stepped staple cartridge with asymmetrical staples
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
US10856868B2 (en) 2016-12-21 2020-12-08 Ethicon Llc Firing member pin configurations
US10959727B2 (en) 2016-12-21 2021-03-30 Ethicon Llc Articulatable surgical end effector with asymmetric shaft arrangement
US10835247B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Lockout arrangements for surgical end effectors
US10893864B2 (en) 2016-12-21 2021-01-19 Ethicon Staple cartridges and arrangements of staples and staple cavities therein
US11317913B2 (en) 2016-12-21 2022-05-03 Cilag Gmbh International Lockout arrangements for surgical end effectors and replaceable tool assemblies
US10639035B2 (en) 2016-12-21 2020-05-05 Ethicon Llc Surgical stapling instruments and replaceable tool assemblies thereof
US10639034B2 (en) 2016-12-21 2020-05-05 Ethicon Llc Surgical instruments with lockout arrangements for preventing firing system actuation unless an unspent staple cartridge is present
US10835245B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Method for attaching a shaft assembly to a surgical instrument and, alternatively, to a surgical robot
US10813638B2 (en) 2016-12-21 2020-10-27 Ethicon Llc Surgical end effectors with expandable tissue stop arrangements
US10667811B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Surgical stapling instruments and staple-forming anvils
US10499914B2 (en) 2016-12-21 2019-12-10 Ethicon Llc Staple forming pocket arrangements
US10667810B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Closure members with cam surface arrangements for surgical instruments with separate and distinct closure and firing systems
US10779823B2 (en) 2016-12-21 2020-09-22 Ethicon Llc Firing member pin angle
US11766260B2 (en) 2016-12-21 2023-09-26 Cilag Gmbh International Methods of stapling tissue
US11766259B2 (en) 2016-12-21 2023-09-26 Cilag Gmbh International Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US10667809B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Staple cartridge and staple cartridge channel comprising windows defined therein
US10675025B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Shaft assembly comprising separately actuatable and retractable systems
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
US10492785B2 (en) 2016-12-21 2019-12-03 Ethicon Llc Shaft assembly comprising a lockout
US10682138B2 (en) 2016-12-21 2020-06-16 Ethicon Llc Bilaterally asymmetric staple forming pocket pairs
US10687809B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Surgical staple cartridge with movable camming member configured to disengage firing member lockout features
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US10695055B2 (en) 2016-12-21 2020-06-30 Ethicon Llc Firing assembly comprising a lockout
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US10973516B2 (en) 2016-12-21 2021-04-13 Ethicon Llc Surgical end effectors and adaptable firing members therefor
US11701115B2 (en) 2016-12-21 2023-07-18 Cilag Gmbh International Methods of stapling tissue
US10448950B2 (en) 2016-12-21 2019-10-22 Ethicon Llc Surgical staplers with independently actuatable closing and firing systems
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
US11497499B2 (en) 2016-12-21 2022-11-15 Cilag Gmbh International Articulatable surgical stapling instruments
US11653917B2 (en) 2016-12-21 2023-05-23 Cilag Gmbh International Surgical stapling systems
US10595882B2 (en) 2017-06-20 2020-03-24 Ethicon Llc Methods for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US11213302B2 (en) 2017-06-20 2022-01-04 Cilag Gmbh International Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US11672532B2 (en) 2017-06-20 2023-06-13 Cilag Gmbh International Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US11871939B2 (en) 2017-06-20 2024-01-16 Cilag Gmbh International Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US11793513B2 (en) 2017-06-20 2023-10-24 Cilag Gmbh International Systems and methods for controlling motor speed according to user input for a surgical instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11090049B2 (en) 2017-06-27 2021-08-17 Cilag Gmbh International Staple forming pocket arrangements
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US10631859B2 (en) 2017-06-27 2020-04-28 Ethicon Llc Articulation systems for surgical instruments
US11766258B2 (en) 2017-06-27 2023-09-26 Cilag Gmbh International Surgical anvil arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11642128B2 (en) 2017-06-28 2023-05-09 Cilag Gmbh International Method for articulating a surgical instrument
US11020114B2 (en) 2017-06-28 2021-06-01 Cilag Gmbh International Surgical instruments with articulatable end effector with axially shortened articulation joint configurations
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US11478242B2 (en) 2017-06-28 2022-10-25 Cilag Gmbh International Jaw retainer arrangement for retaining a pivotable surgical instrument jaw in pivotable retaining engagement with a second surgical instrument jaw
US11696759B2 (en) 2017-06-28 2023-07-11 Cilag Gmbh International Surgical stapling instruments comprising shortened staple cartridge noses
US10695057B2 (en) 2017-06-28 2020-06-30 Ethicon Llc Surgical instrument lockout arrangement
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US11678880B2 (en) 2017-06-28 2023-06-20 Cilag Gmbh International Surgical instrument comprising a shaft including a housing arrangement
US11484310B2 (en) 2017-06-28 2022-11-01 Cilag Gmbh International Surgical instrument comprising a shaft including a closure tube profile
US10758232B2 (en) 2017-06-28 2020-09-01 Ethicon Llc Surgical instrument with positive jaw opening features
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US11000279B2 (en) 2017-06-28 2021-05-11 Ethicon Llc Surgical instrument comprising an articulation system ratio
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US10779824B2 (en) 2017-06-28 2020-09-22 Ethicon Llc Surgical instrument comprising an articulation system lockable by a closure system
US10639037B2 (en) 2017-06-28 2020-05-05 Ethicon Llc Surgical instrument with axially movable closure member
US11826048B2 (en) 2017-06-28 2023-11-28 Cilag Gmbh International Surgical instrument comprising selectively actuatable rotatable couplers
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US11529140B2 (en) 2017-06-28 2022-12-20 Cilag Gmbh International Surgical instrument lockout arrangement
US11083455B2 (en) 2017-06-28 2021-08-10 Cilag Gmbh International Surgical instrument comprising an articulation system ratio
US10786253B2 (en) 2017-06-28 2020-09-29 Ethicon Llc Surgical end effectors with improved jaw aperture arrangements
US11389161B2 (en) 2017-06-28 2022-07-19 Cilag Gmbh International Surgical instrument comprising selectively actuatable rotatable couplers
US10588633B2 (en) 2017-06-28 2020-03-17 Ethicon Llc Surgical instruments with open and closable jaws and axially movable firing member that is initially parked in close proximity to the jaws prior to firing
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US11890005B2 (en) 2017-06-29 2024-02-06 Cilag Gmbh International Methods for closed loop velocity control for robotic surgical instrument
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11478244B2 (en) 2017-10-31 2022-10-25 Cilag Gmbh International Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US11918209B2 (en) 2017-11-10 2024-03-05 Cilag Gmbh International Torque optimization for surgical instruments
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US11896222B2 (en) 2017-12-15 2024-02-13 Cilag Gmbh International Methods of operating surgical end effectors
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11284953B2 (en) 2017-12-19 2022-03-29 Cilag Gmbh International Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11369368B2 (en) 2017-12-21 2022-06-28 Cilag Gmbh International Surgical instrument comprising synchronized drive systems
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US10743868B2 (en) 2017-12-21 2020-08-18 Ethicon Llc Surgical instrument comprising a pivotable distal head
US11576668B2 (en) 2017-12-21 2023-02-14 Cilag Gmbh International Staple instrument comprising a firing path display
US11751867B2 (en) 2017-12-21 2023-09-12 Cilag Gmbh International Surgical instrument comprising sequenced systems
US11337691B2 (en) 2017-12-21 2022-05-24 Cilag Gmbh International Surgical instrument configured to determine firing path
US11583274B2 (en) 2017-12-21 2023-02-21 Cilag Gmbh International Self-guiding stapling instrument
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11883019B2 (en) 2017-12-21 2024-01-30 Cilag Gmbh International Stapling instrument comprising a staple feeding system
US11364027B2 (en) 2017-12-21 2022-06-21 Cilag Gmbh International Surgical instrument comprising speed control
US11849939B2 (en) 2017-12-21 2023-12-26 Cilag Gmbh International Continuous use self-propelled stapling instrument
US11179151B2 (en) 2017-12-21 2021-11-23 Cilag Gmbh International Surgical instrument comprising a display
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11179152B2 (en) 2017-12-21 2021-11-23 Cilag Gmbh International Surgical instrument comprising a tissue grasping system
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11918211B2 (en) 2018-12-28 2024-03-05 Cilag Gmbh International Surgical stapling instrument for use with a robotic system
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11684369B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11350938B2 (en) 2019-06-28 2022-06-07 Cilag Gmbh International Surgical instrument comprising an aligned rfid sensor
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11744593B2 (en) 2019-06-28 2023-09-05 Cilag Gmbh International Method for authenticating the compatibility of a staple cartridge with a surgical instrument
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11229437B2 (en) 2019-06-28 2022-01-25 Cilag Gmbh International Method for authenticating the compatibility of a staple cartridge with a surgical instrument
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11553919B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Method for authenticating the compatibility of a staple cartridge with a surgical instrument
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11918212B2 (en) 2019-08-12 2024-03-05 Cilag Gmbh International Surgical instrument with selectively disengageable drive systems
US11918213B2 (en) 2019-08-20 2024-03-05 Cilag Gmbh International Surgical stapler including couplers for attaching a shaft to an end effector
US11918220B2 (en) 2019-08-30 2024-03-05 Cilag Gmbh International Tissue thickness compensator comprising tissue ingrowth features
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
US11737748B2 (en) 2020-07-28 2023-08-29 Cilag Gmbh International Surgical instruments with double spherical articulation joints with pivotable links
US11638582B2 (en) 2020-07-28 2023-05-02 Cilag Gmbh International Surgical instruments with torsion spine drive arrangements
US11660090B2 (en) 2020-07-28 2023-05-30 Cllag GmbH International Surgical instruments with segmented flexible drive arrangements
US11857182B2 (en) 2020-07-28 2024-01-02 Cilag Gmbh International Surgical instruments with combination function articulation joint arrangements
US11864756B2 (en) 2020-07-28 2024-01-09 Cilag Gmbh International Surgical instruments with flexible ball chain drive arrangements
US11826013B2 (en) 2020-07-28 2023-11-28 Cilag Gmbh International Surgical instruments with firing member closure features
US11871925B2 (en) 2020-07-28 2024-01-16 Cilag Gmbh International Surgical instruments with dual spherical articulation joint arrangements
US11883024B2 (en) 2020-07-28 2024-01-30 Cilag Gmbh International Method of operating a surgical instrument
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11723662B2 (en) 2021-05-28 2023-08-15 Cilag Gmbh International Stapling instrument comprising an articulation control display
US11918215B2 (en) 2021-09-27 2024-03-05 Cilag Gmbh International Staple cartridge with array of staple pockets
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11925353B2 (en) 2021-11-22 2024-03-12 Cilag Gmbh International Surgical stapling instrument comprising internal passage between stapling cartridge and elongate channel
US11925354B2 (en) 2021-11-22 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US11918222B2 (en) 2022-03-30 2024-03-05 Cilag Gmbh International Stapling assembly having firing member viewing windows
US11918208B2 (en) 2022-04-12 2024-03-05 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US11918217B2 (en) 2022-04-25 2024-03-05 Cilag Gmbh International Stapling instrument comprising a staple cartridge insertion stop
US11925346B2 (en) 2022-05-20 2024-03-12 Cilag Gmbh International Surgical staple cartridge including tissue supporting surfaces
US11918210B2 (en) 2022-06-13 2024-03-05 Cilag Gmbh International Staple cartridge comprising a cartridge body including a plurality of wells

Also Published As

Publication number Publication date
US20080275458A1 (en) 2008-11-06

Similar Documents

Publication Publication Date Title
US8257356B2 (en) Guidewire exchange systems to treat spinal stenosis
US8845637B2 (en) Tissue access guidewire system and method
US9492151B2 (en) Multiple pathways for spinal nerve root decompression from a single access point
US8062300B2 (en) Tissue removal with at least partially flexible devices
US8092456B2 (en) Multiple pathways for spinal nerve root decompression from a single access point
US8613745B2 (en) Methods, systems and devices for carpal tunnel release
US9456829B2 (en) Powered tissue modification devices and methods
US9049986B2 (en) Cannulotome
US8652138B2 (en) Flexible tissue rasp
US7578819B2 (en) Spinal access and neural localization
US20080091227A1 (en) Surgical probe and method of making
US20120143206A1 (en) Surgical tools for treatment of spinal stenosis
WO2023245144A1 (en) Integrated instrument assembly

Legal Events

Date Code Title Description
AS Assignment

Owner name: BAXANO, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BLEICH, JEFFERY L.;SCHMITZ, GREGORY P.;LEGUIDLEGUID, ROY;AND OTHERS;REEL/FRAME:021892/0379;SIGNING DATES FROM 20080529 TO 20080610

Owner name: BAXANO, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BLEICH, JEFFERY L.;SCHMITZ, GREGORY P.;LEGUIDLEGUID, ROY;AND OTHERS;SIGNING DATES FROM 20080529 TO 20080610;REEL/FRAME:021892/0379

STCF Information on status: patent grant

Free format text: PATENTED CASE

AS Assignment

Owner name: BAXANO SURGICAL, INC., NORTH CAROLINA

Free format text: CHANGE OF NAME;ASSIGNOR:BAXANO, INC.;REEL/FRAME:031666/0526

Effective date: 20130531

AS Assignment

Owner name: EXWORKS CAPITAL FUND I, L.P., ILLINOIS

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BAXANO SURGICAL, INC.;REEL/FRAME:034947/0732

Effective date: 20150130

Owner name: QUANDARY MEDICAL, LLC, COLORADO

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BAXANO SURGICAL, INC;REEL/FRAME:034954/0526

Effective date: 20150120

AS Assignment

Owner name: AMENDIA, INC., GEORGIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:EXWORKS CAPITAL FUND I, L.P.;REEL/FRAME:035613/0952

Effective date: 20150413

REMI Maintenance fee reminder mailed
AS Assignment

Owner name: ANTARES CAPITAL LP, AS AGENT, ILLINOIS

Free format text: SECURITY INTEREST;ASSIGNOR:AMENDIA, INC.;REEL/FRAME:038587/0753

Effective date: 20160429

FPAY Fee payment

Year of fee payment: 4

SULP Surcharge for late payment
AS Assignment

Owner name: CORTLAND CAPITAL MARKET SERVICES LLC, AS AGENT, IL

Free format text: SECURITY INTEREST;ASSIGNOR:AMENDIA, INC.;REEL/FRAME:038606/0520

Effective date: 20160429

AS Assignment

Owner name: MIS IP HOLDINGS LLC, COLORADO

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:QUANDARY MEDICAL LLC;REEL/FRAME:044343/0094

Effective date: 20170817

AS Assignment

Owner name: AMENDIA, INC., CALIFORNIA

Free format text: ASSIGNMENT CORRECTION UNDER MPEP 323.01(C) AT REEL 034954 FRAME 0526;ASSIGNOR:AMENDIA, INC.;REEL/FRAME:051364/0541

Effective date: 20190822

AS Assignment

Owner name: SCHELL, JEFFREY, COLORADO

Free format text: SECURITY INTEREST;ASSIGNOR:QUANDARY MEDICAL LLC;REEL/FRAME:051797/0221

Effective date: 20180101

AS Assignment

Owner name: SPINAL ELEMENTS, INC., CALIFORNIA

Free format text: MERGER AND CHANGE OF NAME;ASSIGNORS:SPINAL ELEMENTS, INC.;AMENDIA, INC.;REEL/FRAME:051665/0979

Effective date: 20191231

FEPP Fee payment procedure

Free format text: MAINTENANCE FEE REMINDER MAILED (ORIGINAL EVENT CODE: REM.); ENTITY STATUS OF PATENT OWNER: SMALL ENTITY

FEPP Fee payment procedure

Free format text: 7.5 YR SURCHARGE - LATE PMT W/IN 6 MO, SMALL ENTITY (ORIGINAL EVENT CODE: M2555); ENTITY STATUS OF PATENT OWNER: SMALL ENTITY

MAFP Maintenance fee payment

Free format text: PAYMENT OF MAINTENANCE FEE, 8TH YR, SMALL ENTITY (ORIGINAL EVENT CODE: M2552); ENTITY STATUS OF PATENT OWNER: SMALL ENTITY

Year of fee payment: 8